Co-Occurrence of Neurodevelopmental Disorders in Pediatric Sickle Cell Disease.
Eboni I Lance, Alicia D Cannon, Bruce K Shapiro and 3 others
PMID 34397573WHAT IT FOUND
Twenty-four percent of children with sickle cell disease had a neurodevelopmental disorder.
Half of those with language disorders and only 63% of those with ADHD received appropriate therapy or medication. Screen for cognitive issues in all sickle cell patients, as many eligible children miss school support.
Key findings
01Sixty-five of 276 participants (24%) had a neurodevelopmental disorder, with language disorders affecting 9% and ADHD affecting 7% of the clinic population.
02Only five of 24 children with language disorders received speech therapy, and just 11 of 19 children with ADHD had seen a behavioral therapist.
03Neurodevelopmental disorders were significantly associated with higher rates of stroke, seizure, pain crises, and dactylitis, even after adjusting for age and gender.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Retrospective design prevents establishing causality between sickle cell complications and neurodevelopmental disorders. Diagnosis relied heavily on medical records and parent report, which may underestimate the true prevalence of disorders. The study lacked socioeconomic data, a known factor in child development, which could confound associations. Participants with NDD were significantly older than those without, suggesting some younger children may not yet have been diagnosed.
Declared interests
The study was supported by the National Institutes of Health (N.I.H., Extramural). No other specific conflicts of interest or commercial sponsorships were declared in the text.
The easy way to misread this
Do not assume that a normal brain MRI rules out neurodevelopmental risk. Children with sickle cell disease and neurodevelopmental disorders had similar rates of abnormal MRIs to those without disorders, suggesting that functional deficits may exist independently of visible structural damage.