title: The association between cognition and academic performance in Ugandan children surviving malaria with neurological involvement.
abstract: BACKGROUND
  The contribution of different cognitive abilities to academic performance in children surviving cerebral insult can guide the choice of interventions to improve cognitive and academic outcomes. This study's objective was to identify which cognitive abilities are associated with academic performance in children after malaria with neurological involvement.
  
  
  METHODS
  62 Ugandan children with a history of malaria with neurological involvement were assessed for cognitive ability (working memory, reasoning, learning, visual spatial skills, attention) and academic performance (reading, spelling, arithmetic) three months after the illness. Linear regressions were fit for each academic score with the five cognitive outcomes entered as predictors. Adjusters in the analysis were age, sex, education, nutrition, and home environment. Exploratory factor analysis (EFA) and structural equation models (SEM) were used to determine the nature of the association between cognition and academic performance. Predictive residual sum of squares was used to determine which combination of cognitive scores was needed to predict academic performance.
  
  
  RESULTS
  In regressions of a single academic score on all five cognitive outcomes and adjusters, only Working Memory was associated with Reading (coefficient estimate = 0.36, 95% confidence interval = 0.10 to 0.63, p<0.01) and Spelling (0.46, 0.13 to 0.78, p<0.01), Visual Spatial Skills was associated with Arithmetic (0.15, 0.03 to 0.26, p<0.05), and Learning was associated with Reading (0.06, 0.00 to 0.11, p<0.05). One latent cognitive factor was identified using EFA. The SEM found a strong association between this latent cognitive ability and each academic performance measure (P<0.0001). Working memory, visual spatial ability and learning were the best predictors of academic performance.
  
  
  CONCLUSIONS
  Academic performance is strongly associated with the latent variable labelled "cognitive ability" which captures most of the variation in the individual specific cognitive outcome measures. Working memory, visual spatial skills, and learning together stood out as the best combination to predict academic performance.
authors: Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda. pbangirana@yahoo.com
authors: Paul
authors: P
authors: Bangirana
authors: Jeremiah
authors: J
authors: Menk
authors: Chandy C
authors: CC
authors: John
authors: Michael J
authors: MJ
authors: Boivin
authors: James S
authors: JS
authors: Hodges
mesh_terms: D000367:Age Factors; D001288:Attention / Q000502:physiology*; D002648:Child; D003071:Cognition / Q000502:physiology*; D004522:Educational Status; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007858:Learning / Q000502:physiology*; D016014:Linear Models; D016779:Malaria, Cerebral / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008433:Mathematics; D008570:Memory, Short-Term / Q000502:physiology*; D015233:Models, Statistical; D009752:Nutritional Status; D011932:Reading; D012737:Sex Factors; D013037:Spatial Behavior / Q000502:physiology; D014454:Uganda / Q000453:epidemiology
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