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PubMed1999

Attentional ability among survivors of leukaemia.

Attentional ability in 19 survivors of acute lymphoblastic leukaemia and 19 sibling controls was assessed using a neuropsychological model of attention. Analysis revealed that children who had received treatment for leukaemia exhibited significantly poorer performance on measures of the "focus encode" and "focus execute" elements of attention and on measures of the ability to respond to external cues and feedback. No significant differences in performance were found for measures of sustained attention and the ability to shift attention. These results indicate that children who have received treatment for leukaemia may experience highly specific attentional deficits that could have an impact on academic performance, particularly mathematical and reading skills. It is suggested that this underlying attentional deficit might be the source of the neuropsychological sequelae associated with the disease. Future attempts at remediation should incorporate activities specifically designed to ameliorate focusing difficulties.

Antineoplastic Agents↗
PubMed2006

Long-term beneficial effects of dexamethasone on intellectual and neuropsychological outcome of children with pneumococcal meningitis.

A Substantial ratio of bacterial meningitis survivors suffers mild or serious intellectual and neuropsychological handicaps. We organized eighty subjects into three groups: 1) Pneumococcal meningitis (PM) who did not receive dexamethasone, 2) PM who received dexamethasone, 3) Other bacterial meningitis with different etiology. All subjects underwent Bender Visual Motor Gestalt test and age-appropriate Intelligence quotient (IQ) tests. The mean full-scale IQ scoring fell within normal range (90+/-17) in the post-meningitic cohort. There was no statistical difference between two pneumococcal groups regarding full scale IQ testing (88+/-16 and 91+/-18) and Bender-Gestalt scoring (4.0+/-3.3 and 3.8+/-2.6), respectively. However, the subjects with full scale IQ score <85 (below the average) were statistically less in the group with steroid therapy. PM patients who received dexamethasone therapy had statistically better academic performance. As a result, adjuvant steroid therapy has no significant impact on overall intellectual tests in PM subjects. However, dexamethasone seems to diminish development of below the average IQ scoring in PM cases. In addition, PM subjects who received steroids showed better academic achievement. These findings may support the idea of dexamethasone administration prior to first antibiotic dose in PM subjects.

Adolescent↗
PubMed1989

School functioning and disease severity in boys with hemophilia.

There have been few recent studies investigating the scholastic progress of children with hemophilia. The advent of PL94-142, which ensures an appropriate educational program based on a child's specific learning disabilities, and home Factor VIII therapy, which increases the hemophiliac's school attendance and sense of freedom and control, might have had a positive impact on the academic performance of these patients. We investigated past and current educational functioning of 26 boys with hemophilia, using both parental and teacher reports. Twenty-two of these children were administered reading and math achievement tests. Results indicate that school absenteeism is a continuing problem for these children, with the average hemophiliac missing 18 school days in an academic year (median = 11 school days missed); one child had missed 77% of the year. Although these boys had normal intelligence and made average grades in school, six of the 22 tested performed more than two grade levels below expectations in reading and 10 performed greater than two grade levels below expectations in math. School underachievement did not necessarily correlate with disease severity (as indicated by serum factor level), school absenteeism, or grade point average. Although eight parents indicated that their children had past or current school problems, and teachers reported that greater than 50% of the group received special tutoring or classes for learning disabled students, six out of 22 (27%) performed below expectations in either math or reading and yet had no current individual educational remediation plan.(ABSTRACT TRUNCATED AT 250 WORDS)

Absenteeism↗
PubMed2003

Pediatric neurobehavioral diseases in Nevada counties with respect to perchlorate in drinking water: an ecological inquiry.

BACKGROUND: Contamination of drinking water with perchlorate, a known thyrotropic agent, has been demonstrated in areas in the western United States. The health consequences of that exposure have been studied, particularly in the State of Nevada. Previous studies in Nevada, comparing the area with perchlorate in the drinking water and the areas without perchlorate in the drinking water, have found no difference in neonatal thyroxine (T(4)) or thyrotropin (TSH) levels, or in the prevalences of thyroid diseases and thyroid cancer. This same study design has now been applied to the major neurobehavioral diseases of childhood (i.e., attention deficit-hyperactivity disorder (ADHD) and autism) and to school performance in order to determine whether those conditions are more frequent in the area with perchlorate-contaminated water. METHODS: Medical services data on ADHD and autism were obtained from the Nevada Medicaid system for the period of January 1, 1996, to December 31, 2000, with county of residence used as the basis for residential information. Analyses of fourth-grade school performance results for two recent time periods came from the state government. Perchlorate concentrations in drinking water had been determined by local water authorities. ADHD and autism rates for the area with perchlorate in the drinking water (Clark County) were calculated and compared with the rates for the other areas in the state, as were fourth-grade school performances. RESULTS: Analysis of the data from the Nevada Medicaid program shows that the rates for ADHD and for autism in the area where perchlorate was in the drinking water did not exceed the rates in those areas where there was no perchlorate contamination in the drinking water. Fourth-grade standardized test results for students in Clark County were not different from those of the remainder of the state. CONCLUSIONS: This ecological study of children in the exposure area did not find evidence of an increased risk of either ADHD or of autism caused by perchlorate contamination in the drinking water. Furthermore, no difference in overall fourth-grade school performance was observed. No evidence was found that children from the area with perchlorate in the drinking water (up to 24 microg/liter) had either an increase in pediatric neurobehavioral disease (ADHD and autism) or a decrease in fourth-grade academic performance. The limitations of this ecological study relate to diagnostic criteria and ascertainment of geographic and demographic differences and to data on individual residence and water consumption during pregnancy.

Attention Deficit Disorder with Hyperactivity↗
PubMed1992

Prophylactic cranial irradiation dose effects on late cognitive function in children treated for acute lymphoblastic leukemia.

Prophylactic central nervous system treatment has dramatically improved the disease-free survival of children with acute lymphoblastic leukemia (ALL). Long-term neuropsychological sequelae are documented in children who received 2400 cGy prophylactic cranial irradiation. The dose was reduced to 1800 cGy. Available reports on developmental consequences, with short follow-up, have yielded inconsistent results. This study assesses radiation dose effects on cognitive function in children with leukemia who received central nervous system prophylaxis with 2400 cGy versus 1800 cGy whole brain radiotherapy. All leukemic children also received intrathecal methotrexate. A control group of children (treated for Wilms' tumor) received no central nervous system therapy. Nineteen children were treated with 2400 cGy, 16 children with 1800 cGy. The 12 control children received no irradiation. All patients were off therapy for at least 70 months. The 1800 cGy and 2400 cGy patient groups were off therapy for equivalent periods of time (range 70-123 mo) at follow-up testing. Mean age at diagnosis was 49 months, at testing: 142 months. The male to female ratio was 1/1. Standardized psychological tests were administered. Full-Scale, Verbal, and Performance IQ were measured with the Wechsler Intelligence Scale for Children-Revised. Wide Range Achievement Testing evaluated reading, spelling, and arithmetic abilities. Children treated with 1800 cGy performed significantly better than those who received 2400 cGy, and at the same level as controls. There were statistically significant differences between the 1800 cGy and 2400 cGy subjects in all measures. 2400 cGy patients had deficiencies in IQ and academic performance. 1800 cGy patients scored approximately 12 points higher than 2400 cGy children. Eleven children, two in the control group, two in the 1800 cGy, and seven in the 2400 cGy group had IQ scores of less than 90. Eight of the nine irradiated children with deficits had radiotherapy before age 5. These results indicate a mild, but diffuse information processing deficit in children who received 2400 cGy, but not in children who received 1800 cGy. These findings with a minimum of 6 years of follow-up provide new information on late effects of CNS prophylaxis in ALL. Reducing the cranial RT dose from 2400 cGy to 1800 cGy reduced neurotoxicity to acceptable levels.

Brain↗
PubMed1986

Comparison of performances of transfer students and first-year acceptees.

Graduates of the Medical College of Pennsylvania during 1970-1977 were studied to determine the impact of three types of preclinical training on prelicensure clinical performance. The 586 students who comprised these groups consisted of 471 students admitted to the first year, 53 students admitted with advanced standing from U.S. medical or graduate programs, and 62 students admitted with advanced standing from foreign medical schools. Academic performances among the groups differed as measured by scores on the examinations of the National Board of Medical Examiners. However, perceived clinical performances of both transfer groups, as measured by honors awarded in year four and by first-year residency evaluation, were on a par with that of the original matriculants.

College Admission Test↗
PubMed1998

The association between smoking and unhealthy behaviors among a national sample of Mexican-American adolescents.

This study examined the relationship between smoking and participation in unhealthy behaviors among Mexican-American adolescents through a secondary analysis of national data. Mexican-American adolescents (N = 580), ages 10 through 18 years who were interviewed as part of the 1993 Teenage Attitudes and Practices Survey (TAPS II), were selected for analysis. Data collected included smoking status of the adolescent and participation in certain unhealthy behaviors. Among girls in the study, smokers were more likely to not wear a seat belt, be involved in physical fighting, not be involved in organized sports, perform poorly in school, say they like to do risky things, and ride in a car with a drunk or high driver. For boys, smoking was significantly associated with liking to do risky things, fighting, not attending church, and poor academic performance. These results suggest that Mexican-American adolescents who smoke may be at higher risk for engaging in behaviors that could compromise their health and safety, and for not being involved in activities that may exert a protective influence.

Adolescent↗
PubMedDate not supplied

Neonatal predictors of school-based services used by NICU graduates at school age.

BACKGROUND: Ill or premature newborns are at increased risk for ongoing morbidity throughout childhood. Federal legislation now mandates that states provide early intervention, special education, and disability accommodations for children with special needs. Because all children born prematurely do not require all services, targeting services to the children with greatest risk is essential. This study examined whether neonatal characteristics could predict special school-based service use (speech, occupational, physical therapy, special education) in later childhood. METHODS: Subjects were 53 children, ages 7 to 11 years, graduates of one Midwest Level 3 neonatal intensive care unit (NICU). Neonatal data were used to calculate Neurobiologic Risk Scores (NBRS), a sum of illness factors related to brain damage. Birth weight, length of NICU stay, and NBRS were compared to the children's school performance on standardized tools and to report cards. RESULTS: Most children studied were not receiving special school services. The NBRS and parent report of child competency were related (p = 0.01). Length of NICU stay correlated with teachers' reports of children's academic performance (p = 0.04), and to use of special school services use (p = 0.03). As the NBRS score increased, report card performance decreased. CONCLUSIONS: Neonatal characteristics predicted school-age service use. This is important for nurses because predicting which children are most likely to need special services can aid in tracking children at high risk for prompt assessments and referrals. Parents, healthcare providers, educators, advocacy groups, and funding agencies need accurate outcome data to influence health, educational, and social policy decisions.

Child↗
PubMed2005

Access to pocket money and low educational performance predict tobacco use among adolescent boys in Kerala, India.

BACKGROUND: Tobacco use is increasing among adolescents. We conducted this study to find prevalence and correlates of tobacco use among adolescent boys in Trivandrum city, Kerala. METHODS: Using a two-stage cluster sampling technique, 1323 boys (12-19 years) were selected from 14 schools. Information on tobacco use, academic performance, pocket money, and other variables was collected using a questionnaire. Multivariate analyses were done to find associations between current use of tobacco and other variables. RESULTS: Prevalence of current tobacco use was 11.3% (95% CI 9.6-13.0). Current tobacco use was 2.9 times higher among older boys compared to younger boys (OR 2.9, CI 1.6-5.3), 2 times higher among boys whose fathers used tobacco (OR 2.0, CI 1.3-3.1), 2.9 times higher among boys whose friends used tobacco (OR 2.9, CI 1.6-5.1) compared to their counterparts, 3 times higher among boys securing poor (<40% marks) grade compared to those securing excellent (>80% marks) grade (OR 3.0, CI 1.4-6.6), and 4 times higher among those who received pocket money compared to those who did not (OR 4.0, CI 2.2-7.4). CONCLUSIONS: Health programs to quit tobacco are suggested in schools with special emphasis on poor performers, those receiving pocket money, and those whose fathers and friends use tobacco.

Adolescent↗
PubMed2000

Academic and Social Benefits of a Co-enrollment Model of Inclusive Education for Deaf and Hard-of-Hearing Children.

Deaf and hard-of-hearing (d/hh) students are traditionally educated within self-contained programs at residential or special day schools, within self-contained or resource classrooms in public schools, or within regular education classrooms with support provided by an itinerant teacher. The co-enrollment model offers a promising alternative in which these students are educated within a regular education classroom composed of both d/hh and hearing students and team-taught by a teacher of the deaf and a regular education teacher. This article examines the development of one such program and the social and academic performance of the d/hh students within the program. Data on social interaction between d/hh and hearing classmates suggest that specific instructional strategies that promoted students' sign language development, identified d/hh students as "sign language specialists" and grouped d/hh and hearing students during academic activities resulted in increased interaction between these two groups of students. Stanford Achievement Test scores in the areas of reading vocabulary, reading comprehension, mathematical problem solving and procedures indicate that although d/hh students scored below the national normative hearing group, reading comprehension levels exceeded the national normative sample of d/hh students during both years two and three of the program. We discuss the challenges of implementing a co-enrollment program.

Journal Article↗
PubMed1999

Pre-matriculation program at the University of South Florida College of Medicine.

Underrepresented-minority (URM) students at the University of South Florida College of Medicine increased from 4.9% to 10.5% of the total student body from 1991 to 1997. During that period it became clear that some majority and minority students had serious academic difficulties with the first-year curriculum and that a higher proportion of the minority matriculants had difficulties. In response, the college in 1997 created the Summer Pre-matriculation Program to reduce the number of first-year students who had academic difficulty. In the summer before they matriculate in the college, the students complete a six-week program of lectures, small-group discussions, compute-aided instruction, and laboratory instruction in biochemistry, human embryology, and gross anatomy. URM students, non-science majors, and students who have been away from the academic environment (e.g., pursuing medicine as a second career) are given priority for the 20 positions available each year. At the end of the first cohort's first medical school year, the academic performances of program participants and other students were compared, and it was clear that the program participants had performed as well as or slightly better than their counterparts in gross anatomy, biochemistry, and human embryology. Further, the program participants performed at or above the class average in medical school courses for which they had not had targeted instruction during the program. The College of Medicine is committed to diversifying its student body and realizes that diverse students bring varying levels of academic preparation as well as diversity in cultural and academic backgrounds. Concerted efforts such as the pre-matriculation program may be required to normalize the "playing field" at the very outset of medical school and to ensure that every matriculant has an equal opportunity to succeed.

Adult↗
PubMed2002

Joint association of Apgar scores and early neonatal symptoms with minor disabilities at school age.

OBJECTIVE: To examine whether the combination of a low five minute Apgar score and symptoms of neonatal encephalopathy is associated with minor impairments at school age. DESIGN: Population based cohort study. SETTING: Norway. PARTICIPANTS: All 727 children of the cohort were born between 1983 and 1987, had normal birth weights, no congenital malformations, and no major neurological abnormalities. The cohort comprised three groups with five minute Apgar scores of 0-3, 4-6, and 7-10, and were followed from birth to 8-13 years of age by combining data from The Medical Birth Registry, questionnaires, hospital discharge summaries, and the National Insurance Scheme. MAIN OUTCOME MEASURE: Neurodevelopmental impairments such as learning, behavioural, and minor motor difficulties. RESULTS: Children with a five minute Apgar score of 3 or less and signs consistent with neonatal encephalopathy had a significantly increased risk of developing minor motor impairments (odds ratio (OR) 12.8, 95% confidence interval (CI) 2.6 to 63.2), epilepsy (OR 7.0, 95% CI 1.3 to 39.2), need of extra resources in kindergarten (OR 7.0, 95% CI 1.3 to 39.2) or at school (OR 3.4, 95% CI 1.8 to 6.3), and had reduced performance in reading (OR 4.6, 95% CI 2.3 to 9.5) and mathematics (OR 3.3, 95% CI 1.5 to 7.3), compared with children with normal Apgar scores and no neonatal symptoms. They also more often had problems related to tractability, aggressivity, passivity, anxiety, academic performance, and fine motor development. CONCLUSION: Children with low Apgar scores and subsequent signs of cerebral depression who do not develop cerebral palsy may still have an increased risk of developing a variety of neurodevelopmental impairments and learning difficulties.

Apgar Score↗
PubMed1982

Effect of high school students' knowledge of child development and child health on approaches to child discipline.

Because there is an association between the lack of knowledge of normal child development, high and unrealistic expectations for a child's performance, and child abuse, a questionnaire about normal child development, child health maintenance, child discipline aspects of childrearing, and child development was given to a representative sample of high school students in Iowa. Though high school students in Iowa rank high in academic performance, the results of this study indicated that students in grades 9 through 12 had a poor knowledge of child development and child health maintenance. Students whose highest probability of response to a child discipline problem was either to punish or abuse knew less about child development and child health maintenance than their peers. Boys at all grade levels knew less about child development and child health maintenance and were more likely to choose punishment and abuse than girls. Though the causes for child abuse are multifactorial and complex, there is a need to guarantee that all who are at risk for parenthood be informed about child development, child health maintenance, and child discipline to minimize the effects that ignorance of these factors may have on their approaches to discipline and their potential for child abuse.

Adolescent↗
PubMed1998

Assessment and Modification of Flexibility of Cognitive Structures Created in University Courses.

Students' organization of the knowledge that they acquire is an important factor in determining the degree to which it is retained and used. In the past we have used the "fill-in-the-structure" (FITS) task as a direct method of inferring students' cognitive structures of course content (Naveh-Benjamin, Lin & McKeachie, 1995). This study goes one step further by using the FITS task to assess the flexibility of students' cognitive structures of the material learned; that is, whether students are able to relate the same concepts in different ways when the concepts are embedded in two different conceptual frameworks. We assessed the flexibility of students' cognitive structures in three studies by asking students in an ecology course to complete two different structures, each based on a different major dimension in the course. Results of the first study showed that the FITS technique could be used to assess students' ability to use concepts learned in the course appropriately in two different frameworks. The flexibility measures obtained were positively related to academic performance. The second study demonstrated the usefulness of the technique in measuring the development of conceptual flexibility during the course. Finally, the third study employed the technique to show that students' flexible use of concepts can be enhanced by appropriate instruction. Copyright 1998 Academic Press.

Journal Article↗
PubMed2003

The incremental variance problem: enhancing the predictability of academic success in an urban, commuter institution.

The authors identified variables that enhance the predictability of academic performance and retention in an urban, commuter college. They used a longitudinal design with 2 waves of data collection: prior to 1st-semester attendance and again 6 semesters later. The results support the following conclusions: (a) After controlling for precollege indices of academic ability, specific variables within demographic, personal behavior, expectations, and attitudinal domains improved the predictability of grade point average by 15.5% for Whites and 20.3% for Blacks; overall, these analyses accounted for 61% of the variance in grade point average for Whites and 47% for Blacks; (b) for retention, the comparable increment in predictability was 2.5% for Whites and less than 1% for Blacks; overall, the percentage of retention variance accounted for was 42% for Whites and 29% for Blacks; and (c) a paradoxical finding was the combination of a positive correlation between high school average and students' expected grades on tests and a negative correlation between expected and actual grades. The paradox is resolved by citing data that demonstrate (a) a disparity between high school grades and independently measured academic accomplishment; (b) the consequent false attributions students draw about their academic abilities; and (c) the impact of these false attributions on the priority students place on their academic responsibilities.

Adolescent↗
PubMed1991

A model for integrating student and faculty research.

Research productivity is a major criterion for measuring academic performance in most universities today. Because of heavy teaching loads, dental hygiene faculty often have difficulty allocating adequate time to conduct research. Thus, professional advancement might be impeded since faculty may be less productive in the research area than is desired by the academic unit. A method that might assist dental hygiene faculty to become more research productive focuses on student involvement with faculty on collaborative research projects. The purpose of this article is to describe a model designed to enhance the integration of faculty and student research in dental hygiene and to explain the benefits inherent in dental hygiene student involvement with faculty on collaborative research projects.

Dental Hygienists↗
PubMed2004

Behaviour and school performance after brain injury.

PRIMARY OBJECTIVE: To examine the relationship between behavioural problems and school performance following traumatic brain injury (TBI). METHODS AND PROCEDURES SUBJECTS: 67 school-age children with TBI (35 mild, 13 moderate, 19 severe) and 14 uninjured matched controls. Parents and children were interviewed at a mean of 2 years post-TBI. Teachers reported on academic performance and educational needs. Children were assessed using the Vineland Adaptive Behaviour Scales (VABS) and the Weschler Intelligence Scale for Children (WISC-III). MAIN OUTCOMES AND RESULTS: Two-thirds of children with TBI exhibited significant behavioural problems, significantly more than controls (p = 0.02). Children with behavioural problems had a mean IQ aproximately 15 points lower than those without (p = 0.001, 95% CI: 7-26.7). At school, 76%(19) of children with behavioural problems also had difficulties with schoolwork. Behavioural problems were associated with social deprivation and parental marital status (p < or = 0.01). CONCLUSIONS: Children with TBI are at risk of developing behavioural problems which may affect school performance. Children with TBI should be screened to identify significant behavioural problems before they return to school.

Adolescent↗
PubMed1991

Subtle neuropsychological deficits in children with sickle cell disease.

Forty-three children and adolescents (8-16 years old) with sickle cell disease (SCD) and no overt neurologic dysfunction were evaluated with the Wechsler Intelligence Scale for Children-Revised (WISC-R), the Wide Range Achievement Test (WRAT), and an age-appropriate version of the Luria-Nebraska Neuropsychological Battery (LNNB). Thirty similar-aged siblings were controls. WISC-R performance and full-scale IQs were lower (p less than 0.05) for patients than sibling controls. No significant differences were seen on the WRAT. Patients with SCD missed more school days than controls (p less than 0.001) but did not differ from controls in academic performance or the proportion in special education. On the LNNB, scores for patients and controls 13 years and older did not differ. However, young patients had significantly elevated (abnormal) scores compared with controls on the following scales: expressive speech, writing, reading, arithmetic, memory, and pathognomonic. The possibility that subtle neuropsychological deficits in younger patients with SCD reflect either subclinical strokes or a predisposition for strokes merits further investigation in a large multi-institution study.

Adolescent↗