title: Assessment of School Readiness in Chronic Cholestatic Liver Disease: A Pilot Study Examining Children with and without Liver Transplantation.
abstract: Background.Assessment of school readiness evaluates physical, social-emotional, and neuropsychological domains essential for educational success. Cognitive testing of preschool aged children with chronic liver disease may guide more timely interventions and focused efforts by health care providers.Patients and Methods.Children with chronic cholestatic liver disease diagnosed as an infant and still with their native liver (NL) and children who received a liver transplant (LT) before age of 2 years underwent testing with a battery of well-validated pediatric psychometric measures.Results.Eighteen (13 LT, 5 NL) patients (median age of 4.45 and 4.05 years, resp.) were tested. Median Full-Scale IQ was 98 (range 102-116) for LT and 116 [(range 90-106),p= 0.35, NS] for NL subjects. LT recipients had significantly greater visual based difficulties, poorer caregiver rated daily living skills (p= 0.04), and higher levels of executive function based difficulties (e.g., inattention, inhibition).Conclusion.This pilot study highlights the risk of neuropsychological difficulties in early school age children who were under 2 years of age at time of LT. Comprehensive early school age assessment should integrate psychometric measures to identify children at greatest risk, thus allowing for proactive educational intervention.
authors.affiliation: Transplant and Regenerative Medicine Centre, Hospital for Sick Children, Toronto, ON, Canada; Department of Psychology, Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: Anna
authors.identifier: 0000-0002-7719-5673
authors.initials: A
authors.lastname: Gold
authors.affiliation: Department of Rehabilitation, Hospital for Sick Children, Toronto, ON, Canada; Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.
authors.forename: Alaine
authors.initials: A
authors.lastname: Rogers
authors.affiliation: Transplant and Regenerative Medicine Centre, Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: Elizabeth
authors.identifier: 0000-0002-0791-6965
authors.initials: E
authors.lastname: Cruchley
authors.affiliation: Transplant and Regenerative Medicine Centre, Hospital for Sick Children, Toronto, ON, Canada; Division of Pediatric Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Rankin
authors.affiliation: Transplant and Regenerative Medicine Centre, Hospital for Sick Children, Toronto, ON, Canada; Division of Pediatric Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: Arpita
authors.initials: A
authors.lastname: Parmar
authors.affiliation: Transplant and Regenerative Medicine Centre, Hospital for Sick Children, Toronto, ON, Canada; Division of Pediatric Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
authors.forename: Binita M
authors.initials: BM
authors.lastname: Kamath
authors.affiliation: Transplant and Regenerative Medicine Centre, Hospital for Sick Children, Toronto, ON, Canada; Division of Pediatric Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
authors.forename: Yaron
authors.initials: Y
authors.lastname: Avitzur
authors.affiliation: Transplant and Regenerative Medicine Centre, Hospital for Sick Children, Toronto, ON, Canada; Division of Pediatric Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
authors.forename: Vicky Lee
authors.initials: VL
authors.lastname: Ng
mesh_terms: D002675:Child, Preschool; D002779:Cholestasis / Q000150:complications / Q000523:psychology* / Q000601:surgery; D002908:Chronic Disease; D004521:Educational Measurement; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D019965:Neurocognitive Disorders / Q000175:diagnosis* / Q000209:etiology; D009483:Neuropsychological Tests; D010865:Pilot Projects; D011183:Postoperative Complications / Q000523:psychology*; D011594:Psychometrics