Kapp-Simon Kathleen A, Wallace Erin, Collett Brent R, Cradock Mary Michaeleen, Crerand Canice E, Speltz Matthew L
Cleft-Craniofacial Center, Shriners Hospitals for Children, Chicago; and.
Craniofacial Center, Department of Surgery, University of Illinois at Chicago, Illinois;
J Neurosurg Pediatr. 2016 May;17(5):578-88. doi: 10.3171/2015.9.PEDS15238. Epub 2016 Jan 1.
OBJECTIVE The language and memory functions of children with and without single-suture craniosynostosis (SSC) were compared at school age (mean 7.45 years, standard deviation [SD] 0.54 years). The children in this cohort were originally recruited in infancy and prior to cranial surgery for those with SSC. METHODS Individual evaluations of 179 school-aged children with SSC and 183 controls were conducted (70% of the original cohort) using standardized measures of language, learning, and memory. Parents participated in an interview about specialized education interventions and school progress. Parents and teachers completed questionnaires about language development. RESULTS Children with SSC (cases) obtained lower scores than controls on all measures. The adjusted differences in language, learning, and memory scores were modest, with SD ranging from 0.0 to -0.4 (p values ranged from 0.001 to 0.99). Censored normal regression was used to account for intervention services received prior to the school-age evaluation; this increased case-control differences (SD range 0.1 to -0.5, p value range 0.001 to 0.50). Mean scores for cases in each SSC diagnostic group were lower than those for controls, with the greatest differences observed among children with unilateral coronal craniosynostosis. CONCLUSIONS Children with SSC continue to show poorer performance than controls on language, learning, and memory tasks at early elementary school age, even when controlling for known confounders, although mean differences are small. Multidisciplinary care, including direct psychological assessment, for children with SSC should extend through school age with a specific focus on language and conceptual learning, as these are areas of potential risk. Future research is needed to investigate language, memory, and learning for this population during the middle to high school years.
比较患有和未患有单缝颅缝早闭(SSC)的儿童在学龄期(平均7.45岁,标准差[SD]0.54岁)的语言和记忆功能。该队列中的儿童最初是在婴儿期招募的,患有SSC的儿童在颅骨手术前就已纳入。方法:使用标准化的语言、学习和记忆测量方法,对179名患有SSC的学龄儿童和183名对照儿童(占原队列的70%)进行个体评估。家长参与了关于特殊教育干预和学校进展的访谈。家长和教师完成了关于语言发展的问卷。结果:在所有测量指标上,患有SSC的儿童(病例组)得分均低于对照组。语言、学习和记忆得分的调整差异较小,标准差范围为0.0至 -0.4(p值范围为0.001至0.99)。采用删失正态回归来考虑学龄期评估前接受的干预服务;这增加了病例组与对照组的差异(标准差范围为0.1至 -0.5,p值范围为0.001至0.50)。每个SSC诊断组中病例组的平均得分均低于对照组,其中单侧冠状缝颅缝早闭儿童的差异最大。结论:患有SSC的儿童在小学早期的语言、学习和记忆任务中表现仍比对照组差,即使在控制已知混杂因素的情况下,尽管平均差异较小。对患有SSC的儿童进行多学科护理,包括直接的心理评估,应贯穿学龄期,特别关注语言和概念学习,因为这些是潜在风险领域。未来需要开展研究,调查该人群在初中到高中阶段的语言、记忆和学习情况。