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53 Concurrent Cognitive Predictors of School Age Academic Functioning in Children with Neurofibromatosis Type 1
- Kristin M Lee, Ellen Olszewski, Brianna D Yund, Bonita P Klein-Tasman
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 658-659
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Objective:
Children with neurofibromatosis type 1 (NF1) commonly have academic problems. While the neuropsychological profile of children with NF1 is variable, NF1 results in difficulties in a variety of cognitive domains including intellectual functioning, attention, executive functioning. Previous studies have suggested that cognitive functioning may relate to academic functioning in children with NF1; however, the evidence is limited and warrants further examination. Thus, this study will investigate the contribution of several cognitive domains (intellectual functioning, attention, working memory) on academic performance for school age children with NF1.
Participants and Methods:The association between cognitive functioning and academic performance was examined for school age children with NF1 (n = 40; ages 9-13). Intellectual functioning was assessed using the Differential Abilities Scales, Second Edition School-Age Version (DAS-II) General Conceptual Ability (GCA) score. Attention was examined using the DAS-II Recall of Digits-Forward (DF) subtest and Flanker Inhibitory Control and Attention Test (Flanker). Working memory was assessed using the DAS-II Recall of Digits-Backward (DB) subtest. Academic performance was measured using the Wechsler Individual Achievement Test, Third Edition (WIAT-III) Word Reading (WR), Pseudoword Decoding (PD), Reading Comprehension (RC), Numerical Operations (NO), and Math Problem Solving (MPS) subtests.
Results:WR was significantly associated with DAS-II GCA (rs(38) = .689, p < .001) and DF (rs(38) = .470, p = .002) in addition to Flanker (rs(34) = .364, p = .029), but not DAS-II DB (rs(38) = .292, p = .072). PD was significantly correlated with DAS-II GCA (rs(38) = .695, p < .001), DF (rs(38) = .394, p = .012), and DB (rs(38) = .474, p = .002), but not Flanker (rs(34) = .306, p = .070). RC was significantly associated with DAS-II GCA (rs(38) = .483, p = .002) and DF (rs(38) = .346, p = .029), but not DAS-II DB (rs(38) = .306, p = .055) and Flanker (rs(34) = .269, p = .112). NO was significantly correlated with DAS-II GCA fc(38) = .777, p < .001), DF (rs(38) = .555, p = < .001), and DB (rs(38) = .576, p < .001) as well as Flanker (rs(34) = .386, p = .020). MPS was significantly associated with DAS-II GCA (rs(38) = .685, p < .001), DF (rs(38) = .586, p < .001), and DB (rs(38) = .543, p < .001), in addition to Flanker (rs(34) = .420, p = .011). Significant associations had medium to large effect sizes, while non-significant correlations had small to medium effect sizes. Notably, most of the non-significant correlations had trend-level statistical significance.
Conclusions:Concurrent cognitive functioning (intellectual functioning, attention, working memory) was associated with reading-related and mathematics functioning in school age children with NF1. Notably, intellectual functioning had the strongest association with academic performance across all reading-related and mathematics tasks. Future studies should examine the association between academic performance and additional cognitive domains (e.g., language, visuospatial abilities) in children with NF1 across a wider age range to allow for examination of developmental patterns.
63 Comparison of Measures for Identification of Social Difficulties in Early Childhood for Children with Neurofibromatosis Type 1
- Danielle M Glad, Brianna D Yund, Kristin Lee, Christina L Casnar, Bonita P Klein-Tasman
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 739-740
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Objective:
Social functioning patterns vary across measures in children with neurofibromatosis type 1 (NF1; Glad et al., 2021) with broad psychosocial screening measures having shown no impairment (Klein-Tasman et al., 2014; Martin et al., 2012; Sangster et al., 2011) while a more specific social functioning measure indicated poorer social skills (Barton & North, 2004; Huijbregts & de Sonneville, 2011; Loitfelder et al., 2015). The current aims were to characterize caregiver-reported social skills using three different measures and determine which measure appears to best capture social difficulties for young children with NF1.
Participants and Methods:Fifty children with NF1 (31 males; M=3.96, SD=1.05) and 20 unaffected siblings (11 males; M=4.34, SD=0.88) in early childhood (ages 3-6) were rated by a caregiver on one social functioning measure (the Social Skills scale on the Social Skills Rating System (SSRS)) and two broader functioning measures that include assessment of social functioning (the Social Skills scale on the Behavior Assessment System for Children-Second Edition (BASC-2), Social Interaction and Communication domain on the Scales of Independent Behavior-Revised (SIB-R)).
Results:For children with NF1, the SSRS mean standard score was significantly lower than the BASC-2 and SIB-R (f=-5.11, p<.001; f=-4.63, p<.001) while there was no significant difference between the BASC-2 and SIB-R. No significant differences emerged between measures for unaffected siblings. No significant group differences in mean standard score were found for the SSRS, BASC-2 or SIB-R. Fisher’s exact tests revealed the NF1 group had significantly more frequent difficulties than unaffected siblings on the BASC-2 (p=.017) but not on the SSRS or SIB-R. For both groups, Cochran’s Q tests determined a significant difference in the proportion of identified social difficulties across measures (NF1: X2(2)=16.33, p<.001; Siblings: X2(2)=9.25, p=.01). Follow up McNemar’s tests demonstrated significantly more difficulties reported on the SSRS compared to the BASC-2 for both groups (NF1: p<.001; Siblings: p=.016). Significantly more frequent difficulties were also reported on the SSRS compared to the SIB-R for the NF1 group (p=.002) but not for the unaffected siblings group. No difference in the frequency of difficulties was evident between the BASC-2 and SIB-R for either group.
Conclusions:Social skills difficulties appear to be best captured using the SSRS in young children, particularly for children with NF1 as this measure resulted in the lowest mean score and the greatest frequency of difficulties observed within the NF1 group. However, it is notable that group differences in comparison to unaffected siblings were not observed in mean score or frequency of difficulties, such that these young children with NF1 are not showing marked social challenges but rather, social difficulties may be mild when present at this age. Nevertheless, using a measure that specifically targets social functioning, rather than a measure where social functioning is merely a component of a broad measure, appears beneficial to capturing social difficulty. Using measures that best capture social difficulties will contribute to early identification and assessment of intervention effectiveness. Further work with additional age ranges and longitudinal trajectory is needed.