Nora M. Thompson

Analysis of change: modeling individual growth

Research on change is complicated by problems of measurement and analysis stemming from a conceptualization of change as a series of accumulating increments and decrements. In contrast, individual growth curves depict change as a continuous process underlying individual performance. These two perspectives are reviewed, and some problems with the use of difference scores in the study of change are clarified. Traditional methods are contrasted with growth curve analysis for the purposes of measuring change and studying its correlates. An illustrative example of the use of growth curves is provided from research on recovery of cognitive function following pediatric closed head injury.

Verbal and nonverbal skill discrepancies in hydrocephalic children

This study evaluated a large sample (N = 90) of 5- to 7-year-old children with hydrocephalus caused by aqueductal stenosis or prematurity-intraventricular hemorrhage or associated with spina bifida. Comparison groups of normal controls, children with spina bifida and no shunt, and premature children with no hydrocephalus were also evaluated. Comparison of skill discrepancies at two occasions separated by 1 year revealed that hydrocephalic children, as a group, showed poorer nonverbal than verbal skills on measures from the McCarthy Scales of Childrens Abilities, the WISC-R, and composites of neuropsychological skills. No discrepancies in verbal-nonverbal memory were found nor were any discrepancies attributable to etiology or motor demands of the tasks. Consistent with current hypotheses concerning the role of the cerebral white matter in cognitive development, these results show that hydrocephalic children in this age range generally have poorer development of nonverbal cognitive skills relative to their language development.

Motor, Visual-Spatial, and Somatosensory Skills After Closed Head Injury in Children and Adolescents: A Study of Change

Correlational studies of recovery of function following traumatic brain injury have revealed weak, nonspecific relationships between outcome and injury variables. In order to better identify factors affecting recovery, 49 children (aged 6-15 years) were followed prospectively with repeated neuropsychological assessment of motor, visual-spatial, and somatosensory skills up to 5 years postinjury. Analyses of individual growth curves revealed systematic nonlinear changes after injury. Variability among growth patterns related robustly to injury variables. Younger children with severe injuries showed slower growth on visual-spatia l and motor tasks than did older children of similar severity or similarly aged children with less severe injuries. These findings support a hypothesis of increased vulnerability of rapidly emerging skills in young children and argue against an explanation of lowered recovery rates due to concomitant maturational influences on development. Results of studies of cognitive functioning in children after closed head injury (CHI) have consistently demonstrated the presence of deficits in motor skills and nonverbal processing during the subacute phase of recovery (Klonoff, Low, & Clark, 1977; Levin & Eisenberg, 1979a, 1979b). These motor and nonverbal deficits persist one or more years postinjury (Chadwick, Rutter, Brown, Shaffer, & Traub, 1981; Knights et al., 1991; Winogron, Knights, & Bawden, 1984). Additional studies have demonstrated deficits in memory (Levin et al., 1988), language (Levin & Eisenberg, 1979a, 1979b), and behavioral adjustment (Fletcher, Ewing-Cobbs, Miner, Levin, & Eisenberg, 1990). Yet, few studies of neurobehavior al function in children after CHI have addressed changes in performance patterns over time or the actual process of change. To study the recovery process, researchers must use longitudinal measurement of specific abilities and behaviors. For instance, Chadwick, Rutter, Brown, Shaffer, and Traub (1981) prospectively studied the recovery of IQ scores in children up to 27 months after CHI. By testing the children

Gunshot wounds to the brain in children and adolescents: age and neurobehavioral development.

Neurobehavioral outcome after craniocerebral gunshot wounds was evaluated in a prospective, 3-year, longitudinal follow-up of a consecutive case series of 13 children and adolescents. The younger group was composed of seven children, ages 1.5 to 4 years, and the older group contained six children, ages 5 to 14. Outcome measures included the Glasgow Outcome Scale and neuropsychological assessment of intelligence, language, motor, memory, attention, academic achievement, and adaptive behavior. Glasgow Outcome Scale scores at baseline indicated moderate and severe disabilities in 69 and 23%, respectively. At the 3-year follow-up, 85% had moderate disabilities but only 8% were severely disabled. Significant and persistent neurobehavioral deficits varied with developmental level at the time of cerebral insult. Intellectual functioning was clearly more impaired in children younger than 5 years of age at the time of injury than in older children. Cognitive and motor factors were most closely related to deficits in the younger group. Disability in older children and adolescents was associated with impaired attention, adaptive behavior, and behavioral disturbance. Disabilities appear to be at least as severe in our sample after cerebral gunshot wounds as in our studies of severe pediatric closed-head injury. At the time of follow-up, younger children sustaining gunshot wounds had slightly lower intelligence quotient scores and similar receptive language, expressive language, and gross motor scores compared with children with severe closed-head injury. The older gunshot wound patients were significantly more impaired than patients with severe closed-head injuries on measures of adaptive behavior and attention.(ABSTRACT TRUNCATED AT 250 WORDS)

Influence of depression on cognitive functioning in Fragile X females

We sought to determine the frequency of a history of major depression in women with Fragile X syndrome. In addition, we attempted to disentangle the cognitive effects of major depression from those of Fragile X syndrome. Thirty-seven mothers of developmentally delayed children (Fragile X syndrome: n = 18; comparison group n = 19), matched for age, educational level, and socioeconomic status, were administered psychiatric and neuropsychological measures. Women with Fragile X syndrome had a higher frequency of lifetime diagnosis of major depressive disorder (78%) than the comparison group (37%). Mild impairment was seen on visuospatial construction and memory tasks in women with Fragile X syndrome, while women with depression showed subtle deficits in several aspects of visuospatial perception and learning. There was no interaction of Fragile X syndrome and depression in their influence on cognition. The results underscore the importance of considering the influence of depression on cognitive performance in studies of genetic disorders.

Gunshot Wounds to the Brain in Children and Adolescents

Neurobehavioral outcome after craniocerebral gunshot wounds was evaluated in a prospective, 3-year, longitudinal follow-up of a consecutive case series of 13 children and adolescents. The younger group was composed of seven children, ages 1.5 to 4 years, and the older group contained six children, ages 5 to 14. Outcome measures included the Glasgow Outcome Scale and neuropsychological assessment of intelligence, language, motor, memory, attention, academic achievement, and adaptive behavior. Glasgow Outcome Scale scores at baseline indicated moderate and severe disabilities in 69 and 23%, respectively. At the 3-year follow-up, 85% had moderate disabilities but only 8% were severely disabled. Significant and persistent neurobehavioral deficits varied with developmental level at the time of cerebral insult. Intellectual functioning was clearly more impaired in children younger than 5 years of age at the time of injury than in older children. Cognitive and motor factors were most closely related to deficits in the younger group. Disability in older children and adolescents was associated with impaired attention, adaptive behavior, and behavioral disturbance. Disabilities appear to be at least as severe in our sample after cerebral gunshot wounds as in our studies of severe pediatric closed-head injury. At the time of follow-up, younger children sustaining gunshot wounds had slightly lower intelligence quotient scores and similar receptive language, expressive language, and gross motor scores compared with children with severe closed-head injury. The older gunshot wound patients were significantly more impaired than patients with severe closed-head injuries on measures of adaptive behavior and attention.(ABSTRACT TRUNCATED AT 250 WORDS) Language: en

Left Unilateral Neglect in a Preschool Child

The authors present a case of transient left hemispatial inattention following traumatic brain injury in a three‐year‐old child. Computed tomographic scan revealed a small right frontal and a right temporo‐parietal contusion. Stimuli were developed to quantify the response difference between hemifields in this pre‐literate child. Hemispatial inattention showed resolution at 19 days post‐trauma and had completely resolved six months later. These findings suggest that right hemisphere systems subserve visually guided attention before six years of age.

Neuropsychological outcome in children with gunshot wounds to the brain.

&NA; During the years 1985–1987 45 children were hospitalized at our institution for gunshot wounds (GSWs). Twelve suffered GSWs to the brain and five of these survived to be followed by the multidisciplinary team. The purpose of this article is to discuss the neuropsychological outcome of three children who sustained GSWs to the brain during this time period. At our institution, children return for regular follow‐up appointments with the neurosurgeon, neuroscience clinical nurse specialist and neuropsychologist. The neurosurgeon conducts the neurological examination, and the nurse performs a developmental assessment and evaluates teaching and follow‐up needs. During each appointment, the neuropsychologist administers a battery of tests to determine the effects of GSW on intelligence, language, spatial motor skills, academic achievement and adaptive behavior. Case reports are provided to illustrate the results, with nursing implications and future research in the area of outcome of GSW in children discussed.