title: Parent-Reported Executive Dysfunction in Children and Adolescents with Chiari Malformation Type 1.
abstract: BACKGROUND
  Children with Chiari malformation type 1 (CM1) have increasingly presented to neurosurgery clinics. Limited research relating to the cognitive dysfunction experienced by this population has been completed. In adults, inhibition problems and executive dysfunction have been documented.
  
  
  METHODS
  Seventy-seven parental reports of children with CM1 were included in the study. Parents completed questions on a scale rating daily executive functioning as well as reporting on common neurological symptoms.
  
  
  RESULTS
  The sample consisted of 41 males and 36 females with a mean age of 133.57 ± 42.18 months. Thirty-eight subjects had had decompression surgery. The most common neurological symptoms included: headache (69%), a history of pain (31%) and gait disturbance (20%). One third of the sample demonstrated overall executive functioning impairment, with working memory elevations being most prevalent (44%). Depression, gender, age and decompression surgery were not related to executive dysfunction.
  
  
  CONCLUSIONS
  The parental report of executive dysfunction in children with CM1 was higher than the standardized healthy sample. Metacognitive problems, especially working memory and initiation problems were most prevalent. A quick parental rating scale identifying children with executive dysfunction may be beneficial for neurosurgeons and assist with referrals for a more comprehensive neuropsychological assessment.
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Ill., USA.
authors.forename: Maureen
authors.initials: M
authors.lastname: Lacy
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Ellefson
authors.forename: Samantha
authors.initials: S
authors.lastname: DeDios-Stern
authors.forename: David M
authors.initials: DM
authors.lastname: Frim
mesh_terms: D000293:Adolescent; D001139:Arnold-Chiari Malformation / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010290:Parents; D011795:Surveys and Questionnaires