Assessment of School Readiness in Chronic Cholestatic Liver Disease: A Pilot Study Examining Children with and without Liver Transplantation

• Published in: Canadian journal of gastroenterology & hepatology Vol. 2017; no. 2017; pp. 1 - 8
• Main Authors: Ng, Vicky Lee, Kamath, Binita M., Parmar, Arpita, Rankin, Stephanie, Cruchley, Elizabeth, Rogers, Alaine, Gold, Anna, Avitzur, Yaron
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Publishing Corporation 01.01.2017; Hindawi; Hindawi Limited; John Wiley & Sons, Inc; Wiley
• Subjects: Analysis; Child, Preschool; Childhood neuropsychological tests; Cholestasis - complications; Cholestasis - psychology; Cholestasis - surgery; Chronic Disease; Diagnosis; Educational aspects; Educational Measurement; Educational programs; Female; Humans; Liver diseases; Liver Transplantation; Male; Neurocognitive Disorders - diagnosis; Neurocognitive Disorders - etiology; Neuropsychological Tests; Pilot Projects; Postoperative Complications - psychology; Psychological aspects; Psychometrics; School readiness
• ISSN: 2291-2789; 2291-2797
• DOI: 10.1155/2017/9873945

Background. Assessment of school readiness evaluates physical, social-emotional, and neuropsychological domains essential for educational success. Cognitive testing of preschool aged children with chronic liver disease may guide more timely interventions and focused efforts by health care providers. Patients and Methods. Children with chronic cholestatic liver disease diagnosed as an infant and still with their native liver (NL) and children who received a liver transplant (LT) before age of 2 years underwent testing with a battery of well-validated pediatric psychometric measures. Results. Eighteen (13 LT, 5 NL) patients (median age of 4.45 and 4.05 years, resp.) were tested. Median Full-Scale IQ was 98 (range 102–116) for LT and 116 [(range 90–106), p=0.35, NS] for NL subjects. LT recipients had significantly greater visual based difficulties, poorer caregiver rated daily living skills (p=0.04), and higher levels of executive function based difficulties (e.g., inattention, inhibition). Conclusion. This pilot study highlights the risk of neuropsychological difficulties in early school age children who were under 2 years of age at time of LT. Comprehensive early school age assessment should integrate psychometric measures to identify children at greatest risk, thus allowing for proactive educational intervention.