Medical and Socioeconomic Risk Factors for Academic and Psychological Outcomes in Pediatric Sickle Cell Disease.

Abstract

Risk factors for poor neuropsychological outcomes are not fully understood in youth with sickle cell disease (SCD). We examined the associations between medical factors (SCD genotype, silent infarct/stroke, etc), socioeconomic factors (insurance type), and neuropsychological outcomes (reading and math achievement, psychological symptoms) in youth with SCD. A chart review was conducted for 108 Black/African American youth with SCD (M_age = 10.80, SD = 3.53, 54.6% males) referred for neuropsychological evaluation. Patients were administered Wechsler-series tests of intelligence and academic achievement. Psychological symptoms were measured using the caregiver report Child Behavior Checklist. Zero-order correlations, analyses of variance (ANOVAs), and hierarchical linear regression models examined the associations between variables. Youth with less severe SCD genotypes (SC/SBeta+ thalassemia) had more externalizing problems. Youth with Medicaid/no insurance had more internalizing, externalizing, and somatic symptoms. Low full-scale intelligence quotient (FSIQ) strongly predicted poor academic achievement scores above other factors. Results highlight the importance of early neuropsychological/psychosocial screenings in SCD.