a Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia and Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania , Philadelphia , PA , USA.
b Department of Psychology, Drexel University , Philadelphia , PA , USA.
Child Neuropsychol. 2019 Nov;25(8):1116-1124. doi: 10.1080/09297049.2019.1588957. Epub 2019 Mar 25.
Children with perinatal arterial ischemic stroke (PAIS) have increased rates of attention and executive functioning (EF) weaknesses. Research in other pediatric disorders has documented poor consistency between parent report of these skills and performance-based measures. We compared these data sources in children with PAIS. Forty full-term (≥37 weeks) children ages 3-16 (median = 7.2 years; 58% male) with PAIS completed neuropsychological testing and composite scores were created for seven attention and EF domains (Processing Speed; Attention; Working Memory; Verbal Retrieval; Inhibitory Control; Flexibility/Shifting; Planning). Parents completed "real-world" functioning questionnaires (ADHD Rating Scale-IV, BRIEF). Correlational analysis were used to compare parent and performance measures. Correlations between ADHD Rating Scale-IV scores and the performance-based Attention and Inhibition composite scores were nonsignificant. Significant negative correlations were found between the BRIEF GEC and performance-based Verbal Retrieval and Processing Speed composites, but remaining GEC/composite comparisons were nonsignificant. Analyses between parent report BRIEF index scores and the corresponding performance-based domain identified one significant negative correlation between the BRIEF Working Memory Index and the Working Memory composite score. While children with PAIS demonstrate difficulties in attention and EF on both parent report and performance measures, little significance was found in comparisons of these two types of measures. There may be several explanations for this dissociation: measures assessing different aspects of the same underlying construct; performance-based measures lacking ecological validity; and parents underestimating/underreporting their child's deficits. Thus, multiple sources of informant and performance data are necessary to make more accurate conclusions about functioning in these domains.
围产期动脉缺血性脑卒中（PAIS）患儿的注意力和执行功能（EF）缺陷发生率较高。其他儿科疾病的研究记录表明，这些技能的家长报告与基于表现的测量之间一致性较差。我们在 PAIS 患儿中比较了这些数据来源。40 名足月（≥37 周）年龄在 3-16 岁（中位数=7.2 岁；58%为男性）的 PAIS 患儿完成了神经心理学测试，并为七个注意力和 EF 领域（处理速度；注意力；工作记忆；言语检索；抑制控制；灵活性/转换；计划）创建了综合评分。家长完成了“真实世界”功能问卷（ADHD 评定量表-IV，BRIEF）。使用相关分析比较家长和表现测量。ADHD 评定量表-IV 评分与基于表现的注意力和抑制综合评分之间的相关性无统计学意义。BRIEF GEC 与基于表现的言语检索和处理速度综合评分之间存在显著负相关，但其余 GEC/综合评分比较无统计学意义。在家长报告的 BRIEF 指数评分与相应的基于表现的领域之间的分析中，BRIEF 工作记忆指数与工作记忆综合评分之间存在一个显著的负相关。虽然 PAIS 患儿在家长报告和表现测量中都表现出注意力和 EF 困难，但这两种类型的测量之间的比较没有发现显著意义。这种分离可能有几个解释：评估同一潜在结构的不同方面的测量；缺乏生态有效性的基于表现的测量；以及家长低估/漏报他们孩子的缺陷。因此，需要来自多个信息源和表现数据来更准确地得出关于这些领域功能的结论。
