James Woo-Sam

Recovery of Motor and Intellectual Function in Children Sustaining Severe Head Injuries

Forty‐six patients aged from 2 to 18 years were evaluated 1–7 years after sustaining severe head trauma. The average duration of coma in this series was 7 weeks.

Physical recovery after severe closed head trauma in children and adolescents

Three hundred forty-four patients under 18 years of age with severe closed head injuries, comatose over 24 hours, were followed prospectively for a minimum of one year. Motor vehicles were involved in 82% of the injuries. Seventy-three percent of the patients regained independence in ambulation and self-care, 10% remained partially dependent in self-care and achieved only limited ambulation, 9% regained consciousness but were totally dependent, and 8% remained comatose. A favorable prognosis for recovery of motor function can be made if the duration of coma is less than three months. Complications of prolonged hypertension, ventricular enlargement, and seizures significantly decrease the probability of achieving physical independence. Although mortality following severe head injury is decreasing, neurologic sequelae in the survivors are statistically unchanged since 1970. Improved neurosurgical management in recent years has not increased the percentage of severely disabled survivors.

Review of the Criterion-Related Validity of the WISC–III: The First Five Years:

A review of studies comparing the WISC–III to other measures of intelligence and achievement indicates the revision is continuing to meet the standards established by its predecessor, the WISC–R. Correlations are substantial, both for measures of ability and achievement; however, compared to the WISC–R, the WISC–III Full Scale IQ tends to be about six points lower, probably reflecting the “Flynn effect” (1984). As a consequence, eligibility for programs in special education may be negatively affected.

Cultural differences on WISC-R verbal items

Abstract The item difficulty patterns of four groups of nonreferred, average children— Anglos, Blacks, Chicanos and Bermudians—were compared on each of the verbal subtests of the Wechsler Intelligence Scale for Children-Revised. The analysis was done for 7 1 2 years old and 10 1 2 year olds separately. Although this procedure identified a small number of items differentially difficult for one group of children or another, the item difficulty curves for the four groups were remarkably parallel, considering the differences in the childrens cultures.

A longitudinal comparison of the WISC‐R and WAIS‐R

The degree of comparability between the WISC-R and WAIS-R over time was assessed for two samples of referred adolescents of borderline intelligence intially administered a WISC-R and retested on the WAIS-R after three years. Results indicated that the WAIS-R significantly overestimated the WISC-R IQs by 3 to 5 points. Differences were most marked at the lower ability levels; as IQs aproached average, scores were increasingly comparable.

Socio-Economic Status and Post-Trauma Intelligence in Children with Severe Head Injuries

Study of 46 severely head-injured children suggests that the degree of intellectual recovery post-trauma is best predicted by the age at injury. These younger children generally fared less well than older children. However, socio-economic affiliation also was a determining factor. The majority of younger children were from the lower socio-economic class and proportionately more younger than older children of lower-class affiliation functioned at the subnormal level. In contrast, for the middle-class group proportionally as many younger as older children functioned at the subnormal level.

Location of injury and Wechsler indices of mental deterioration

Application of four Wechsler indices of mental deterioration to 95 cases of known head-injured Ss indicates that there are between index differences but that except for the Wechsler Revised index, locus of injury does not affect the efficiency of the indices. The findings were explained on the basis that trauma to the head results in two broad and measurable psychological effects: (1) generalized impairment of concentration and attention and (2), depending upon locus of injury, additional impairments of selective coping skills. In this study, a mixed parietal injury appears associated with deficient conceptualization skills either verbal or motor.

IS RETESTING WITH THE WISC-III A DEFENSIBLE PROCEDURE ?

Kaufmans warning against using the WISC–III to retest children previously administered the WISC–R is not supported by this review of 16 studies of referred children retested after a minimum of 9 months.

Speed as a Variable on Three Wisc Performance Subtests

This study tested the hypothesis that for younger children of normal intellect, speed of performance plays a minimal if not negligible role in determining the obtained scores on the Block Design, Object Assembly, and Picture Arrangement subtests. It was further argued that if such were the case, then it was not necessary to exclude these subtests in the evaluation of the orthopedically handicapped child capable of manipulating the test materials. Under these circumstances, a poor showing could not be attributed to loss of bonus credits because of slow performance. Results based on five groups of children of normal intelligence ages 7 1/2 through 13 1/2 yr. (N = 119) indicate that the Block Design and Object Assembly subtests essentially measure a power function through age 10 1/3. Speed is a determinant by age 13 1/2. On the Picture Arrangement subtest, the power function holds only at age 7 1/2. However, a score within normal limits is possible without speed bonuses through age 9 1/2.