Neurocognitive development of young children with sickle cell disease through three years of age.
OBJECTIVE
To determine (1) the neurocognitive development of children with sickle cell disease (SCD) from 6 months through 36 months of age, (2) the independent and combined contributions of biomedical risk and parenting risk to child neurocognitive functioning, and (3) the independent and combined contributions of biomedical risk, parent cognitive processes, and family functioning to parent adjustment.


METHODS
The study sample included 89 African American children and their parents served through the Duke University-University of North Carolina Comprehensive Sickle Cell Center. Measures of cognitive and psychomotor development were obtained at 6, 12, 24, and 36 months of age, and parents completed self-report measures of the cognitive processes of daily stress and attributional style, psychological adjustment, and family functioning.


RESULTS
There was no significant decrease in psychomotor functioning (PDI) over time but cognitive functioning (MDI) declined, with a significant decrease occurring between the 12- and 24-month assessment points. At 24 months, poorer cognitive functioning was associated with parenting risk, in terms of a learned-helplessness attributional style, and biomedical risk, in terms of HbSS phenotype. Levels of psychological distress within the clinical range were reported by 24% of the parents, and poorer parent adjustment was associated with high levels of daily stress, less knowledge about child development, lower expectations of efficacy, and HbSC phenotype.


CONCLUSIONS
The findings indicate that young children with SCD are at risk for neurocognitive impairment and provide support for the initiation of early intervention studies to promote neurocognitive development.
Thompson
Robert J
RJ
Duke University Medical Center, USA. bobt@asdean.duke.edu
Gustafson
Kathryn E
KE
Bonner
Melanie J
MJ
Ware
Russell E
RE
D000755:Anemia, Sickle Cell / Q000175:diagnosis / Q000235:genetics / Q000523:psychology*; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis / Q000235:genetics / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006380:Helplessness, Learned; D006450:Hemoglobin SC Disease / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D006451:Hemoglobin, Sickle / Q000235:genetics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007360:Intelligence; D007389:Internal-External Control; D008297:Male; D009483:Neuropsychological Tests; D016487:Parenting / Q000523:psychology; D010641:Phenotype; D011596:Psychomotor Disorders / Q000175:diagnosis / Q000235:genetics / Q000523:psychology*; D012307:Risk Factors
D006451:Hemoglobin, Sickle