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[Physical and mental development after early surgery of myeloceles].

These investigations are based on 143 myelocele operations (=93 % spina bifida cystica), with a follow-up period of 3-15 years. There was an associated hydrocephalus in 88%. In 114 (89%) of the children with hydrocephalus a ventriculo-atrial shunt was inserted. In three quarters of the cases this was done within the first three months of life. In general the chindren remained "shunt-dependent" and only in 9% was it possible to remove it later. Of the surviving children about 25% were restricted to a wheel-chair and of them 7% had severe mental defects. Their physical state as regards head growth,height and weight showed about 70% of average values. Neurogenic disturbances of bladder emptying were present in 90% of the children. The expectation of survival to age 13 was 65%. Using the Hamburg Wechsler Intelligence Test for Children (Hawik) the intellectual development showed an average of 97 +/- 15-219 With only a trifling deviation this corresponds to the normal mean. The Bühler-Hetzer test also showed normal values in 70%. All the children are able to receive some training, which ranged from special schools right up to grammar school. We have particularly gone into the problem of the social rehabilitation of these children.

Adolescent↗

Stereotypes and steroids: using a psychobiosocial model to understand cognitive sex differences.

To further our understanding of cognitive sex differences, we studied the relationship between menstrual phase (via serum estradiol and progesterone levels) and cognitive abilities and cognitive performance in a sample of medical students in eastern Turkey. As expected, we found no sex differences on the Cattell "Culture Fair Intelligence Test" (a figural reasoning test), with females scoring significantly higher on a Turkish version of the Finding A's Test (rapid word knowledge) and males scoring significantly higher on a paper-and-pencil mental rotation test. The women showed a slight enhancement on the Finding A's Test and a slight decrement in Cattell scores during the preovulatory phase of their cycle that (probably) coincided with a rise in estrogen. There were also small cycle-related enhancements in performance for these women on the mental rotation test that may reflect cyclical increases in estrogen and progesterone. Additional analyses showed an inverted U-shaped function in level of estradiol and the Cattell Test. Finally, for women who were tested on Day 10 of their menstrual cycle, there was a negative linear relationship between their Cattell scores and level of progesterone. Stereotypes about the cognitive abilities of males and females did not correspond to performance on the mental rotation or Finding A's Test, so the sex-typical results could not be attributed to either stereotype threat or stereotype activation. For practical purposes, hormone-related effects were generally small. Variations over the menstrual cycle do not provide evidence for a "smarter" sex, but they do further our understanding of steroidal action on human cognitive performance.

Adolescent↗

Neuropsychological assessment of children with medulloblastoma.

There is little information available about specific psychological deficits experienced by children with medulloblastoma. Most of the data reported so far are based on standardized intelligence tests which are only a partial representation of a child's total behavioral repertoire. Clinical neuropsychological assessment is a well-standardized and accurate means of identifying specific deficits. However, this psychometric approach to assessment must also be combined with an individualized, subjective assessment of each patient. These data must be obtained longitudinally in order to show changes over time.

Behavior↗

[Intelligence in children with cleft lip and palate].

In a group of 174 children with clefts lip and palate the articulation-connected (sprachgebundene) and non-articulation-connected (nicht sprachgebundene) intelligence have been inquired by the HAWIE- and HAWIK-intelligence test. For this group a general average IQ of 106,6 resulted, that means 6,6 IQ points above a normal 100 level found out for this test. There is a significant difference between the verbal and the action-part, the action-part prevailing in nearly all IQ fields. With due restraint the qualitative interpretation of the subtests discovers a surprising high ability in respect of the verbal forming of conception, the verbal knowledge and the ability to adapt to social norms.

Child↗

Intelligibility of tracheoesophageal speech among naive listeners.

Tracheoesophageal (TE) speech is now the most common method of voice rehabilitation after total laryngectomy. The speech intelligibility of laryngectomees who use TE speech as their primary mode of communication was evaluated by 20 "naive" listeners. Two speech intelligibility tests were administered using phonetically balanced rhyming words or lists of spondee words. The overall intelligibility for the group of laryngectomees was 76%, with a wide range of variability among the individual TE speakers. We concluded that TE speech is significantly less intelligible to naive listeners than normal laryngeal speech; further refinement of voice rehabilitation for laryngectomees is needed.

Female↗

Frontal lobe-dependent functions in treated phenylketonuria: blood phenylalanine concentrations and long-term deficits in adolescents and young adults.

Even early-treated phenylketonurics may suffer from phenylalanine-related deficits. Elevated phenylalanine concentrations can interfere with the development and function of the CNS. Outcome beyond childhood has not been extensively investigated. This long-term study was performed to determine whether adolescents and young adults with PKU show frontal lobe-dependent deficits when compared to diabetic patients. The comparative study covered 35 PKU patients, 13-21 years of age (mean 17.8 years), and 35 diabetic patients matched for sex, age and socioeconomic status. Patients were assessed for IQ (Culture Fair Intelligence Test), information processing (Trail Making Test), and selective and sustained attention (Stroop Task, Test d-2). Assessments were repeated within a 3-year follow-up. PKU patients showed no increase in blood phenylalanine concentrations at follow-up. They had significantly poorer test results than the diabetic patients at both assessment times. Within the tests, however, this was due to reduced performance speed but not to deficits in specific frontal lobe-dependent functions. Elevated phenylalanine concentrations seem to exert a global effect slowing performance speed. This effect is enduring in adolescence and early adulthood.

Adolescent↗

Enhancing emotional intelligence in the health care environment: an exploratory study.

Emotional intelligence (EI), or knowledge of how emotions function in self and others, is a popular construct in both scientific and professional communities. Current theoretical models suggest that EI is a combination of dynamic skills that can be learned and enhanced through participation in targeted intervention programs. Although popular, few if any of the aforementioned interventions have been subjected to empirical scrutiny. Consistent with calls for efficacy studies of intervention programs, the purpose of this exploratory study was to examine the effect of an adventure-based intervention on the EI of employees of a multisite dental practice. Fifteen individuals completed the Mayer-Salovey-Caruso Emotional Intelligence Test before and after participation in a day-long intervention. Results suggest that the intervention had a small but positive effect on the participants' EI and that improvements in the 4 branches of EI varied within employee subgroups. Implications for future research and practical considerations for the health care environment are discussed.

Adult↗

Seizures as a predictor of long-term neurodevelopmental outcome in survivors of neonatal extracorporeal membrane oxygenation (ECMO).

A longitudinal, prospective study was conducted to determine the long-term neurodevelopmental outcome in neonatal extracorporeal membrane oxygenation (ECMO) survivors with and without seizures. One hundred sixty-two ECMO survivors from March 1985 until November 1995 were eligible for follow-up. Sixty-four returned at preschool age (4-6 years). Thirty-nine infants did not experience neonatal seizures (group 1); however, 25 exhibited seizures before or during ECMO (group 2). Twelve infants referred for ECMO, but managed medically, served as a clinical comparison group (group 3). At school age (7-9 years), 32 ECMO children (16 with seizures) returned for neuropsychologic evaluation. The results indicated that the preschool seizure group (group 2) demonstrated a significantly lower mean IQ than group 1 or 3 (P = .002). Furthermore, 56% of group 2 had IQ scores < or =84 (> or =1 SD below the mean). Group 2 also exhibited significantly higher rates of cerebral palsy (P < or = .001) and speech-language disorder than group 1 or 3 (P < .001). At school age, the seizure group continued to perform below average on intelligence testing, with 50% scoring < or =84 and 38% receiving special education. This study extends the previous findings that seizures associated with neonatal ECMO are a primary risk factor for neurodevelopmental sequelae and confirms the need for long-term follow-up to assist with academic programming.

Child Development↗

Intelligence and brain size in 100 postmortem brains: sex, lateralization and age factors.

The neural basis of variation in human intelligence is not well delineated. Numerous studies relating measures of brain size such as brain weight, head circumference, CT or MRI brain volume to different intelligence test measures, with variously defined samples of subjects have yielded inconsistent findings with correlations from approximately 0 to 0.6, with most correlations approximately 0.3 or 0.4. The study of intelligence in relation to postmortem cerebral volume is not available to date. We report the results of such a study on 100 cases (58 women and 42 men) having prospectively obtained Full Scale Wechsler Adult Intelligence Scale scores. Ability correlated with cerebral volume, but the relationship depended on the realm of intelligence studied, as well as the sex and hemispheric functional lateralization of the subject. General verbal ability was positively correlated with cerebral volume and each hemisphere's volume in women and in right-handed men accounting for 36% of the variation in verbal intelligence. There was no evidence of such a relationship in non-right-handed men, indicating that at least for verbal intelligence, functional asymmetry may be a relevant factor in structure-function relationships in men, but not in women. In women, general visuospatial ability was also positively correlated with cerebral volume, but less strongly, accounting for approximately 10% of the variance. In men, there was a non-significant trend of a negative correlation between visuospatial ability and cerebral volume, suggesting that the neural substrate of visuospatial ability may differ between the sexes. Analyses of additional research subjects used as test cases provided support for our regression models. In men, visuospatial ability and cerebral volume were strongly linked via the factor of chronological age, suggesting that the well-documented decline in visuospatial intelligence with age is related, at least in right-handed men, to the decrease in cerebral volume with age. We found that cerebral volume decreased only minimally with age in women. This leaves unknown the neural substrate underlying the visuospatial decline with age in women. Body height was found to account for 1-4% of the variation in cerebral volume within each sex, leaving the basis of the well-documented sex difference in cerebral volume unaccounted for. With finer testing instruments of specific cognitive abilities and measures of their associated brain regions, it is likely that stronger structure-function relationships will be observed. Our results point to the need for responsibility in the consideration of the possible use of brain images as intelligence tests.

Aged↗

Neurocognitive abilities for a clinically depressed sample versus a matched control group of normal individuals.

Depressed patients have been reported to show deficits in tasks that demand memory, planning/sequencing, speeded responding, and effortful responding. Many studies of depressed patients have used inadequate instrumentation or poor control groups. In this investigation, the cognitive performance of 44 patients diagnosed as clinically depressed was compared with the performance of a control group of normal individuals that closely matched the clinical group on the variables of age, gender, race or ethnic group, and educational attainment. The groups were compared on the tasks that compose the Kaufman Adolescent and Adult Intelligence Test (KAIT), which includes reliable and valid measures of most pertinent areas of purported deficit in depressed patients. Multivariate analyses of variance indicated that the depressed and control groups did not differ significantly on KAIT variables, but the depressed patients did differ significantly from the control group on the delayed versus immediate recall of verbal information.

Adolescent↗

Intellectual development in children whose mothers received propylthiouracil during pregnancy.

Standard intelligence tests were administered to twenty-eight children who had been exposed to PTU in utero and thirty-two non-exposed siblings. There was no significant difference in results between the two groups. The present study suggests that with careful attention, pregnant women with thyrotoxicosis can be treated with propylthiouracil without interfering with subsequent intellectual development in the offspring.

Adolescent↗

Psychological evaluation of Japanese astronaut applicants.

In 1991, a new psychological selection procedure was employed during the selection of Japanese Space Station astronauts. It was based on international selection criteria developed by an international psychological/psychiatric working group. A total of 372 individuals--fewer than expected--submitted applications for Space Station astronaut in Japan. Of the applicants, 233 were given several psychological written tests [Anxiety Scale, Performance Test, General Aptitude Test Battery, and Environmental Adjustment Test Battery (EATB)] in Phase I of the selection. Forty-five applicants went on to take the General Aptitude Test Battery (GATB), Human Assessment Method (a group test), a semi-structured psychological interview and an intelligence test in Phase II of the selection. All applicants were found to be highly intelligent. Interestingly, an unexpectedly large number of candidates were disqualified by the newly developed EATB. Assessment of individual functioning in a group (the Human Assessment Method) resulted in no applicant being ranked in either the "qualified with reservation" (QR) or "disqualified" (DQ) category. Much has been learned from this initial application of psychological "select-in" testing, but further efforts are needed to improve both psychological criteria and evaluation methods and to determine their reliability and validity.

Adaptation, Psychological↗

Personality traits of 47,XYY and 47,XXY males found among juvenile delinquents.

The mental features of nine 47,XYY males and six 47,XXY males found among Japanese juvenile delinquents were examined. The results of intelligence tests suggested a slight impairment among 47,XYY and 47,XXY males. The psychiatric interviews and the psychological tests revealed that 47,XYY males had a high activity level while 47,XXY males had a low one. Analyses of the offense type and psychophysiological features supported these findings. As the activity level is considered to be largely determined genetically, the extra Y is suspected to be responsible for the high activity level and the extra X in males to be responsible for the low activity level.

Adolescent↗

On the nature of intelligence.

Our concept of intelligence has been heavily influenced by the development of intelligence tests as screening devices in education and personnel selection. An alternative approach is to begin with a theory of the process of cognition and identify those aspects of individual mental performance that should be important on theoretical grounds. Three classes of performance have been identified. These deal with a person's choice of an internal representation for a problem, strategies for manipulating the representation, and abilities to execute elementary information processing steps required by the strategy.

Cognition↗

Neurocognitive impairment in lead-exposed children of Andean lead-glazing workers.

OBJECTIVE: The level of lead (Pb) exposure necessary to induce intellectual impairment has not been firmly established. Some studies using conventional language-based intelligence tests have reported that pediatric blood lead (PbB) levels lower than 10 microg/dL (0.483 micromol/L) are associated with neurocognitive impairment. However, these tests may introduce cultural biases in the assessment of intellectual functioning. The objective of this study was to assess the effects of PbB concentration on nonverbal intelligence in Andean children with chronic environmental Pb exposure using a nonlanguage-based test of cognitive functioning. METHODS: Using Raven Colored Progressive Matrices (RCPM) as a measure of nonverbal intelligence, this study investigated the effects of Pb exposure (biomarker: PbB levels) on intellectual functioning in 188 chronically Pb-exposed children (age range: 5.33-11.67 years) of Ecuadorian Andean Pb-glazing workers. RESULTS: The mean PbB level of the 188 children was 29.3 microg/dL (range: 3.5-94.3 microg/dL). Forty-seven children had PbB levels <10 microg/dL (Centers for Disease Control and Prevention [CDC] I classification), of which 30 had abnormal (ie, < or =25th percentile) RCPM standard scores. Of the 141 children with PbB levels > or =10 microg/dL, 97 had abnormal RCPM scores. A regression analysis revealed a statistically significant negative association (r = -0.331, P < 0.0001) between PbB level and RCPM standard score. Conversion of RCPM standard scores to estimated IQ scores showed an approximate two-point decrease in IQ for each 10-microg/dL increment in PbB level from 10 to >70 microg/dL. CONCLUSIONS: Performance on a test of nonverbal intelligence was inversely associated with chronic Pb exposure in Andean children with PbB levels below and above the CDC risk management level of 10 microg/dL, with the decline in test scores suggesting a dose-response relationship.

Adult↗

Intellectual functioning in a 70-year-old urban population.

A subsample of 229 persons from the population study "70-year-olds in Gothenburg" was studied with different intelligence tests. The non-response was 15%, and another 4% refused to take part in the psychological examination or had handicaps which made the performance of all or some of the tests impossible. Measurements were made of verbal meaning (SRB1), reasoning (SRB2), spatial ability (SRB3), perceptual speed (Ps-if) and logical thinking and observation (Raven's Coloured Progressive Matrices). There were no differences in the tests between men and women except with Raven's Coloured Progressive Matrices, where the men had a better score. Amongst the women, those who had received a longer education had a better score compared with those who had had less education. Norm-tables for the different tests are presented. As far as could be judged from cross-sectional comparisons the average general cognitive capability was good, even though the 70-year-olds to a higher degree were suffering from mental disorders than younger individuals and more often were living in social situations that could have influenced basic physical and mental functions. The perceptual speed was the only ability that showed a marked change at the age of 70.

Age Factors↗

Use of adaptive behavior measures and overrepresentation of black students in programs for students with mild mental retardation.

The use of adaptive behavior information for classification and placement of black and white students with mild mental retardation was compared and overrepresentation of black students in special classes was analyzed. Adaptive behavior measures were not used to the same extent as general intelligence tests for either group, despite court decisions and recommendations by authoritative sources. Direct comparisons on general intellectual functioning and several indices of adaptive behavior yielded few differences, suggesting that an equal treatment conception of fairness was achieved despite substantial overrepresentation of black students in programs for students with mild mental retardation. Use of adaptive behavior needs to improve significantly to comply with legal requirements.

Adolescent↗

Neglect of dropout underestimates effects of death in longitudinal studies.

Investigations of terminal declines in mental abilities have assessed cognitive performance at a single time point and retrospectively compared survivors and decedents at a single later census date. Neglect of outcomes other than death, such as dropout, causes a loss of information on the relative frailty of survivors and deceased persons before the census date and on incidence of mortality and frailty among survivors after the census date. This discards information on differences in health status between younger and older survivors. The Heim AH4-1 intelligence test was given to 4,228 people between the ages of 42 and 92 years, and both deaths and dropouts were logged during three successive census periods during the subsequent 11 years. Within and across census periods, effects of impending death and dropout did not differ, decreasing with time from initial assessment. Thus the effects of terminal decline, or indeed of any other variable affecting cognitive performance, are miscalculated if dropout is ignored.

Adult↗