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Predictive validity of developmental screening in young children with sickle cell disease: a longitudinal follow‐up study
Author(s) -
Schatz Jeffrey,
Schlenz Alyssa M,
Smith Kelsey E,
Roberts Carla W
Publication year - 2018
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.13689
Subject(s) - medicine , pediatrics , cohort , cognition , disease , stroke (engine) , cohort study , predictive validity , medical record , quality of life (healthcare) , clinical psychology , psychiatry , mechanical engineering , nursing , engineering
Aim To assess the predictive validity of developmental screenings in children with sickle cell disease ( SCD ) for academic outcomes and stroke risk. Method Parent questionnaires and medical record data were collected for a cohort receiving developmental screenings between September 2004 and May 2008 as toddlers or early school age. Screening outcomes were dichotomized (positive, negative) by a priori criteria. Questionnaires assessed school and social functioning, services received, and quality of life. Medical record data assessed general SCD morbidity and stroke risk. Results Forty‐one toddlers (mean age 2y 5mo; 25 males, 16 females) and 49 early school‐age children (mean age 6y 5mo; 26 males, 23 females) completed follow‐up. The mean follow‐up period was 8 years 6 months (range 6.1–10.8y). For toddlers, positive screenings for language delays predicted lower academic performance ( p =0.023). For older children, positive screenings for cognitive delays predicted more frequent academic/attentional problems at school ( p <0.001), grade retention ( p =0.007), and lower academic performance ( p =0.001). Positive screenings were associated with an earlier onset of school problems and lower quality of life. Positive screenings for language/cognitive delays predicted increased stroke risk (both p <0.05). Interpretation Screening for language or cognitive development in young children with SCD predicts academic outcomes and stroke risk. What this paper adds Developmental screening predicts academic outcomes in sickle cell disease. Children with concerning language/cognitive screenings have early‐onset school difficulties. Developmental screenings may help predict cerebrovascular complications.