Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan.
Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan.
Semin Thorac Cardiovasc Surg. 2020;32(2):302-310. doi: 10.1053/j.semtcvs.2019.10.017. Epub 2019 Nov 4.
To examine whether neurodevelopment at preschool age predicts IQ levels and needs for special education services in school-age children with single ventricle (SV) physiology. Thirty-five patients with SV physiology were assessed using the Bayley Scale of Infant and Toddler Development (BSID) II or III at 3 years and the Wechsler Intelligence Scale for Children-Fourth Edition (WISC) at 8 years. Whether the children were receiving special education services was also determined. Factors associated with the mental developmental index (MDI) of the BSID, the full-scale IQ (FSIQ) of the WISC, and special education services were also analyzed. The MDI and FSIQ of children with SV physiology were significantly lower than the values in healthy children (P < 0.01). The MDI at 3 years was moderately correlated with FSIQ at 8 years (P < 0.01, R = 0.41). Ten patients (28.6%) received special education services in their school. Children with MDI <85 were more likely than those with MDI ≥85 to require special education services at school age (53% and 10%, respectively, P < 0.01). Weight at birth and stage II were correlated with the MDI, extracorporeal circulation time at stage II was correlated with FSIQ, and age at Fontan operation was correlated with FSIQ and special education services. The toddler neurodevelopment index may predict not only IQ levels but also the need for special education services in school-age children. Children with low neurodevelopmental scores need to be followed closely for a long time.
为了探究在患有单心室(SV)生理的学龄儿童中,学龄前的神经发育是否能预测智商水平和接受特殊教育服务的需求。35 名 SV 生理患儿分别在 3 岁时接受贝利婴幼儿发展量表(BSID)第二版或第三版、8 岁时接受韦氏儿童智力量表第四版(WISC)的评估。同时也确定了患儿是否接受特殊教育服务。还分析了与 BSID 的精神发育指数(MDI)、WISC 的全量表智商(FSIQ)和特殊教育服务相关的因素。SV 生理患儿的 MDI 和 FSIQ 显著低于健康儿童(P<0.01)。3 岁时的 MDI 与 8 岁时的 FSIQ 中度相关(P<0.01,R=0.41)。10 名患儿(28.6%)在学校接受特殊教育服务。MDI<85 的患儿比 MDI≥85 的患儿更有可能在学龄期需要接受特殊教育服务(分别为 53%和 10%,P<0.01)。出生体重和 II 期与 MDI 相关,II 期体外循环时间与 FSIQ 相关,Fontan 手术年龄与 FSIQ 和特殊教育服务相关。幼儿神经发育指数可能不仅能预测智商水平,还能预测学龄儿童接受特殊教育服务的需求。神经发育评分较低的患儿需要长期密切随访。