J Neurosurg Pediatr. 2016 Jan 1:1-11. [Epub ahead of print]
Language, learning, and memory in children with and without single-suture craniosynostosis.
Kapp-Simon KA1,2, Wallace E3, Collett BR3,4, Cradock MM5, Crerand CE6,7, Speltz ML3,4.
1Cleft-Craniofacial Center, Shriners Hospitals for Children, Chicago; and.
2Craniofacial Center, Department of Surgery, University of Illinois at Chicago, Illinois;
3Seattle Children’s Research Institute; and.
4Department of Psychiatry and Behavioral Medicine, University of Washington School of Medicine, Seattle, Washington;
5Department of Psychology, St. Louis Children’s Hospital, St. Louis, Missouri;
6Center for Biobehavioral Health, The Research Institute at Nationwide Children’s Hospital; and.
7Departments of Pediatrics and Plastic Surgery, The Ohio State University College of Medicine, Columbus, Ohio.
OBJECTIVE The language and memory functions of children with and without single-suture craniosynostosis (SSC) were compared at school age (mean 7.45 years, standard deviation [SD] 0.54 years). The children in this cohort were originally recruited in infancy and prior to cranial surgery for those with SSC. METHODS Individual evaluations of 179 school-aged children with SSC and 183 controls were conducted (70% of the original cohort) using standardized measures of language, learning, and memory. Parents participated in an interview about specialized education interventions and school progress. Parents and teachers completed questionnaires about language development. RESULTS Children with SSC (cases) obtained lower scores than controls on all measures. The adjusted differences in language, learning, and memory scores were modest, with SD ranging from 0.0 to -0.4 (p values ranged from 0.001 to 0.99). Censored normal regression was used to account for intervention services received prior to the school-age evaluation; this increased case-control differences (SD range 0.1 to -0.5, p value range 0.001 to 0.50). Mean scores for cases in each SSC diagnostic group were lower than those for controls, with the greatest differences observed among children with unilateral coronal craniosynostosis. CONCLUSIONS Children with SSC continue to show poorer performance than controls on language, learning, and memory tasks at early elementary school age, even when controlling for known confounders, although mean differences are small. Multidisciplinary care, including direct psychological assessment, for children with SSC should extend through school age with a specific focus on language and conceptual learning, as these are areas of potential risk. Future research is needed to investigate language, memory, and learning for this population during the middle to high school years.