title: Risk Factors for Attention and Behavioral Issues in Pediatric Sickle Cell Disease.
abstract: BACKGROUND
  Children with sickle cell disease have an increased risk of neurodevelopmental disorders such as attention deficit hyperactivity disorder, intellectual disability, and specific learning disabilities. Little research has been done to characterize the sickle cell disease-related characteristics associated with neurodevelopmental disorders in the sickle cell disease population.
  
  
  METHODS
  This study was a retrospective chart review involving the outpatient records of 2 medical centers, Kennedy Krieger Institute and Johns Hopkins Hospital. Participants in the study included 59 children with sickle cell disease with a documented neurodevelopmental diagnosis, specifically attention deficit hyperactivity disorder, attention issues, behavioral issues, executive dysfunction, specific learning disabilities in math, reading, and reading comprehension, intellectual disabilities, developmental delay, fine motor disorders, language disorders, or autism spectrum disorders.
  
  
  RESULTS
  Children with sickle cell disease type hemoglobin S-β thalassemia plus had significantly higher odds of attention issues than children with sickle cell disease type hemoglobin SS (OR = 17.0, 95% CI = 1.99-145.00, P < .02). Children with sickle cell disease and a reported history of asthma had significantly higher odds of behavioral issues than children with sickle cell disease without a history of asthma, after adjustment for gender and sickle cell disease type (exact OR = 19.53, 95% CI = 1.16-1369.72, P < .04).
  
  
  CONCLUSIONS
  Children with sickle cell disease may have increased risk for certain neurodevelopmental diagnoses based on their disease characteristics and associated comorbidities. These preliminary study results should be explored in a larger database.
authors.affiliation: Kennedy Krieger Institute, Baltimore, MD, USA Johns Hopkins University School of Medicine, Baltimore, MD, USA lance@kennedykrieger.org.
authors.forename: Eboni I
authors.initials: EI
authors.lastname: Lance
authors.affiliation: Kennedy Krieger Institute, Baltimore, MD, USA Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Comi
authors.affiliation: Kennedy Krieger Institute, Baltimore, MD, USA Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Michael V
authors.initials: MV
authors.lastname: Johnston
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: James F
authors.initials: JF
authors.lastname: Casella
authors.affiliation: Kennedy Krieger Institute, Baltimore, MD, USA Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Bruce K
authors.initials: BK
authors.lastname: Shapiro
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000453:epidemiology*; D001249:Asthma / Q000453:epidemiology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D015142:Baltimore / Q000453:epidemiology; D002653:Child Behavior Disorders / Q000453:epidemiology; D015897:Comorbidity; D002658:Developmental Disabilities / Q000453:epidemiology; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000453:epidemiology; D008297:Male; D065886:Neurodevelopmental Disorders / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014505:Urban Population
keywords: ADHD; neurodevelopmental disorders; sickle cell disease