title: Intellectual and academic functioning of school-age children with single-suture craniosynostosis.
abstract: OBJECTIVE
  We compared the developmental status of school-age children with single-suture craniosynostosis (case group) and unaffected children (control group). Within the case group we compared the performance of children distinguished by location of suture fusion (sagittal, metopic, unicoronal, lambdoid).
  
  
  METHODS
  We administered standardized tests of intelligence, reading, spelling, and math to 182 case participants and 183 control participants. This sample represented 70% of those tested during infancy before case participants had corrective surgery.
  
  
  RESULTS
  After adjustment for demographics, case participants' average scores were lower than those of control participants on all measures. The largest observed differences were in Full-Scale IQ and math computation, where case participants' adjusted mean scores were 2.5 to 4 points lower than those of control participants (Ps ranged from .002 to .09). Adjusted mean case-control differences on other measures of achievement were modest, although case deficits became more pronounced after adjustment for participation in developmental interventions. Among case participants, 58% had no discernible learning problem (score <25th percentile on a standardized achievement test). Children with metopic, unicoronal, and lambdoid synostosis tended to score lower on most measures than did children with sagittal fusions (Ps ranged from <.001 to .82).
  
  
  CONCLUSIONS
  The developmental delays observed among infants with single-suture craniosynostosis are partially evident at school age, as manifested by lower average scores than those of control participants on measures of IQ and math. However, case participants' average scores were only slightly lower than those of control participants on reading and spelling measures, and the frequency of specific learning problems was comparable. Among case participants, those with unicoronal and lambdoid fusions appear to be the most neurodevelopmentally vulnerable.
authors.affiliation: Departments of Psychiatry and Behavioral Sciences and Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington; matt.speltz@seattlechildrens.org.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Speltz
authors.affiliation: Departments of Psychiatry and Behavioral Sciences and Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington;
authors.forename: Brent R
authors.initials: BR
authors.lastname: Collett
authors.affiliation: Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington;
authors.forename: Erin R
authors.initials: ER
authors.lastname: Wallace
authors.affiliation: Department of Clinical and Translational Research, The Forsyth Institute, Cambridge, Massachusetts; Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts;
authors.forename: Jacqueline R
authors.initials: JR
authors.lastname: Starr
authors.affiliation: Department of Psychology, St Louis Children's Hospital, St Louis, Missouri; Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri;
authors.forename: Mary Michaeleen
authors.initials: MM
authors.lastname: Cradock
authors.affiliation: Center for Craniofacial Disorders, Children's Healthcare of Atlanta, Atlanta, Georgia;
authors.forename: Lauren
authors.initials: L
authors.lastname: Buono
authors.affiliation: Pediatrics, University of Washington, Seattle, Washington; Craniofacial Center, Seattle Children's Hospital, Seattle, Washington;
authors.forename: Michael
authors.initials: M
authors.lastname: Cunningham
authors.affiliation: Department of Surgery, Northwestern University, Chicago, Illinois; and Shriners Hospital for Children, Chicago, Illinois.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Kapp-Simon
mesh_terms: D000124:Achievement; D002648:Child; D003398:Craniosynostoses / Q000150:complications / Q000601:surgery*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007360:Intelligence / Q000502:physiology*; D007858:Learning / Q000502:physiology*; D007859:Learning Disabilities / Q000209:etiology* / Q000523:psychology; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D013537:Sutures
keywords: craniosynostosis; neurodevelopment; school functioning