Revisiting the Factor Structure of the German WISC-V for Clinical Interpretability: An Exploratory and Confirmatory Approach on the 10 Primary Subtests

With the exception of a recently published study and the analyses provided in the test manual, structural validity is mostly uninvestigated for the German version of the Wechsler Intelligence Scale for Children - Fifth Edition (WISC-V). Therefore, the main aim of the present study was to examine the latent structure of the 10 WISC-V primary subtests on a bifurcated extended population-representative German standardization sample (N=1,646) by conducting both exploratory (EFA; n=823) and confirmatory (CFA; n=823) factor analyses on the original data. Since no more than one salient subtest loading could be found on the Fluid Reasoning (FR) factor in EFA, results indicated a four-factor rather than a five-factor model solution when the extraction of more than two suggested factors was forced. Likewise, a bifactor model with four group factors was found to be slightly superior in CFA. Variance estimation from both EFA and CFA revealed that the general factor dominantly accounted for most of the subtest variance and construct reliability estimates further supported interpretability of the Full Scale Intelligence Quotient (FSIQ). In both EFA and CFA, most group factors explained rather small proportions of common subtest variance and produced low construct replicability estimates, suggesting that the WISC-V primary indexes were of lower interpretive value and should be evaluated with caution. Clinical interpretation should thus be primarily based on the FSIQ and include a comprehensive analysis of the cognitive profile derived from the WISC-V primary indexes rather than analyses of each single primary index.

Cognitive and Behavioral Profiles of Children with Aspartylglucosaminuria: A Case Series

Aspartylglucosaminuria (AGU) is a rare lysosomal storage disorder with an autosomal recessive inheritance. It affects the aspartylglucosaminidase (AGA) gene and causes a deficiency in activity of the enzyme N-aspartyl-β-glucosaminidase with resultant accumulation of glycoasparagines in body tissues. Children with AGU present with developmental delays in cognitive and language skills. Currently, information on cognition and behavior of children with AGU is limited. This case series presents the neuropsychological and behavioral profiles of three children with AGU assessed at two time points. All the three children had full-scale intelligence quotient (IQ) scores in the intellectual disabled range (<70). IQ had declined since their previous cognitive assessment 1 to 2 years prior. Other cognitive skills were significantly below expected levels. Parents reported several behavioral problems and adaptive difficulties. The findings challenge current beliefs that cognition is impaired but stable in children with declines seen in a short time.

Neurodevelopmental outcomes at age 5 among children born preterm: EPIPAGE-2 cohort study

Objectives To describe neurodevelopment at age 5 among children born preterm. Design Population based cohort study, EPIPAGE-2. Setting France, 2011. Participants 4441 children aged 5½ born at 24-26, 27-31, and 32-34 weeks Main outcome measures Severe/moderate neurodevelopmental disabilities, defined as severe/moderate cerebral palsy (Gross Motor Function Classification System (GMFCS) ≥2), or unilateral or bilateral blindness or deafness, or full scale intelligence quotient less than minus two standard deviations (Wechsler Preschool and Primary Scale of Intelligence, 4th edition). Mild neurodevelopmental disabilities, defined as mild cerebral palsy (GMFCS-1), or visual disability ≥3.2/10 and <5/10, or hearing loss <40 dB, or full scale intelligence quotient (minus two to minus one standard deviation) or developmental coordination disorders (Movement Assessment Battery for Children, 2nd edition, total score less than or equal to the fifth centile), or behavioural difficulties (strengths and difficulties questionnaire, total score greater than or equal to the 90th centile), school assistance (mainstream class with support or special school), complex developmental interventions, and parents’ concerns about development. The distributions of the scores in contemporary term born children were used as reference. Results are given after multiple imputation as percentages of outcome measures with exact binomial 95% confidence intervals. Results Among 4441 participants, 3083 (69.4%) children were assessed. Rates of severe/moderate neurodevelopmental disabilities were 28% (95% confidence interval 23.4% to 32.2%), 19% (16.8% to 20.7%), and 12% (9.2% to 14.0%) and of mild disabilities were 38.5% (33.7% to 43.4%), 36% (33.4% to 38.1%), and 34% (30.2% to 37.4%) at 24-26, 27-31, and 32-34 weeks, respectively. Assistance at school was used by 27% (22.9% to 31.7%), 14% (12.1% to 15.9%), and 7% (4.4% to 9.0%) of children at 24-26, 27-31, and 32-34 weeks, respectively. About half of the children born at 24-26 weeks (52% (46.4% to 57.3%)) received at least one developmental intervention which decreased to 26% (21.8% to 29.4%) for those born at 32-34 weeks. Behaviour was the concern most commonly reported by parents. Rates of neurodevelopment disabilities increased as gestational age decreased and were higher in families with low socioeconomic status. Conclusions In this large cohort of children born preterm, rates of severe/moderate neurodevelopmental disabilities remained high in each gestational age group. Proportions of children receiving school assistance or complex developmental interventions might have a significant impact on educational and health organisations. Parental concerns about behaviour warrant attention.

The Association Between Reading the Mind in the Eyes Test Performance and Intelligence Quotient in Children and Adolescents With Asperger Syndrome

Background: There has been an extensive debate about a potential association between intelligence and social cognition. In this study, we aimed to assess the association between social cognition as measured with the Reading the Mind in the Eyes test (RMET) and intelligence as measured with the fourth edition of the Wechsler Intelligence Scale for Children (WISC-IV) in children and adolescents diagnosed with Asperger Syndrome (AS).Methods: We conducted a cross-sectional study among 84 children diagnosed with AS aged 6–16 years (mean = 11.64; standard deviation = 2.75; 92.9% males). We analyzed the association between RMET performance and WISC-IV total score as well as the association between RMET performance and each of the four WISC-IV indexes (processing speed index, PSI; working memory index, WMI; perceptual reasoning index, PRI, and verbal comprehension index, VCI).Results: We found a positive correlation between RMET performance and full-scale intelligence quotient (r = 0.340; p &lt; 0.01), VCI (r = 0.310; p &lt; 0.01), PRI (r = 0.401; p &lt; 0.01), and WMI (r = 0.292; p &lt; 0.01). In the linear regression model, age was a significant predictor of RMET score (β = 0.409; p &lt; 0.001) as was PRI (β = 0.309; p = 0.019).Conclusion: Our results suggest that intelligence quotient positively influences RMET performance, indicating that intelligence increases social cognition in individuals diagnosed with AS. However, weak-to-moderate size effects were found. This study contributes to understanding the mechanisms underlying the disturbance of social cognition in children and adolescents diagnosed with AS.

Effects of Folic Acid Combined with DHA Supplementation on Cognitive Function and Amyloid-β-Related Biomarkers in Older Adults with Mild Cognitive Impairment by a Randomized, Double Blind, Placebo-Controlled Trial

Background: The neuroprotective benefits of combined folic acid and docosahexaenoic acid (DHA) on cognitive function in mild cognitive impairment (MCI) patients are suggested but unconfirmed. Objective: To explore the effects of 6-month folic acid + DHA on cognitive function in patients with MCI. Methods: Our randomized controlled trial (trial number ChiCTR-IOR-16008351) was conducted in Tianjin, China. We divided 160 MCI patients aged > 60 years into four regimen groups randomly: folic acid (0.8 mg/day) + DHA (800 mg/day), folic acid (0.8 mg/day), DHA (800 mg/day), and placebo, for 6 months. Cognitive function and blood amyloid-β peptide (Aβ) biomarker levels were measured at baseline and 6 months. Cognitive function was also measured at 12 months. Results: A total of 138 patients completed this trial. Folic acid improved the full-scale intelligence quotient (FSIQ), arithmetic, and picture complement scores; DHA improved the FSIQ, information, arithmetic, and digit span scores; folic acid + DHA improved the arithmetic (difference 1.67, 95% CI 1.02 to 2.31) and digital span (1.33, 0.24 to 2.43) scores compared to placebo. At 12 months, all scores declined in the intervention groups. Folic acid and folic acid + DHA increased blood folate (folic acid + DHA: 7.70, 3.81 to 11.59) and S-adenosylmethionine (23.93, 1.86 to 46.00) levels and reduced homocysteine levels (–6.51, –10.57 to –2.45) compared to placebo. DHA lower the Aβ40 levels (–40.57, –79.79 to –1.35) compared to placebo (p < 0.05), and folic acid + DHA reduced the Aβ42 (–95.59, –150.76 to –40.43) and Aβ40 levels (–45.75, –84.67 to –6.84) more than DHA (p < 0.05). Conclusion: Folic acid and DHA improve cognitive function and reduce blood Aβ production in MCI patients. Combination therapy may be more beneficial in reducing blood Aβ-related biomarkers.

Cognitive Developmental Trajectories in Adult ADHD Patients and Controls: A Comparative Study

Objective: There is an updated conceptualization of whole-lifespan attention-deficit hyperactivity disorder (ADHD), promoted by awareness of probable persistence of impairment into adulthood. We investigated cognition trajectories from adolescence to mid-adulthood in ADHD. Method: Data of 240 patients with ADHD and 244 healthy controls (HCs) were obtained; clinical symptoms and neuropsychological functions were assessed using the various tests. Results: Compared to HCs, patients with ADHD except 35 to 44 age interval showed lower full scale intelligence quotient. They showed decreased verbal comprehensive scores except in the 35 to 44 age interval and working memory scores in all intervals. In the Comprehensive Attention Test, patients with ADHD showed increased working memory error frequencies except in the 15 to 17 age interval and divided attention omission error in all intervals. Conclusion: Adults with ADHD showed deficits not in simple attention but in complex attention, including divided attention and working memory.

RARE-04. INTELLECTUAL DEVELOPMENT IN CHILDREN WITH PEDIATRIC CRANIOPHARYNGIOMA AFTER TUMOR REMOVAL

INTRODUCTION Intellectual assessment in children with craniopharyngioma after tumor removal is still unknown. We assessed intellectual development in children who underwent microsurgical resection in our institute over the last twelve years. MATERIALS AND METHODS Ten children among 41 patients with craniopharyngioma treated and followed at Kagoshima University Hospital between 2007 and 2019 were reviewed. We also assessed intellectual development in 10 years or younger children with craniopharyngioma one year after tumor removal. Intelligence was assessed using the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-Ⅳ). RESULTS Ten children underwent microsurgical tumor removal. The mean age at surgery was 5.8 (range 1–10) years. Transcranial approach was performed in 8 children, transsphenoidal approach in two children. The mean follow up period was 110 months. Gamma knife surgery (GKS) was performed in 6 children less than 6 months after first surgery. Regional recurrences occurred in 5 children, and additional GKS was performed in four children, second microsurgical removal in one child. Severe obesity with a transient electrolyte imbalance occurred in one child. Eight children with GH deficiency underwent GH replacement therapy. Eight children were assessed working memory index (WMI), processing speed index (PSI), Perceptual reasoning index (PRI), and verbal comprehension index (VCI) using WISC 4. Each mean value of WMI, PSI, and PRI was lower than VCI, except for 2 children with normal full scale intelligence quotient. CONCLUSION WMI, PSI and PRI in children with intellectual disabilities were lower tendency than VCI after surgical removal of craniopharyngiomas in the present study.

INTELLIGENCE ANALYSIS AMONG RURAL LEARNERS IN MOROCCO

The full scale intelligence quotient is a strong predictor of educational success. The aim of this study was to calculate the full scale intelligence quotient (FSIQ) of Moroccan rural students in the Safi region. the psychometric test Wechsler intelligence scale for childrenand adolescents -5th edition WISC V was used by administering the five indexes, namely the verbal comprehension index, visuospatial index, fluid reasoning index, working memory index and processing speed index, to compare them to the average ofthe Wechsler tests. The study carried on 104 students (46 girls and 58 boys) between the ages of 12 and 15 years old, 67% of the students were boarders and 33% were external students.We administered all the 15 subtests of WISC V on each participant.The results showed that the verbal comprehension index was higher than the other four indexes in WISC V. In terms of correlations among the five indexes, the results show different types of relationships among the test indexes.

EVALUATION OF INTELLIGENCE SCORES AMONG STUDENTS FROM MOROCCAN URBAN AREAS

Our study carried on Moroccan students from urban areas.Thebasis will be for calculating the full-scaleintelligence quotient FSIQ, which is positively, predicts school results, and determining the psychometric profiles of the samples participating in this study. By administering the fifteen subtests of the Wechsler Intelligence Scale for Children -5th Edition WISC V and comparing the results to the average of the Wechsler tests. We have administered all subtests ofWISC V, an individual general intelligence test for children aged between 6 and 16 based on the g-factor since the inception of the first Wechsler test. We ensure that every student participating in this study from the city of Safi has passed all the subtests. The participants are 101 students (59 girls and42 boys) aged between 11and 15years old. The results of the samples who are urban public school students show a median of full-scale intelligence quotient, the average value of the verbal comprehension index is higher than the other four indexes of WISC V. In terms of correlations, the results show two types of relationships between the five indexes on the scale.

Neurocognition in Congenital Central Hypoventilation Syndrome: influence of genotype and ventilation method

Background Congenital Central Hypoventilation Syndrome (CCHS) is characterized by central hypoventilation due to abnormal autonomic control of breathing and global dysautonomia. Patients harbour heterozygous PHOX-2B gene mutations which are polyalanine repeats of various lengths in most of the cases. A few previous studies have reported learning difficulties and neuropsychological disorders in patients with CCHS. The aims of the present study were (1) to explore the intellectual abilities of a group of children with CCHS followed up in the centre of reference for CCHS in France using the Wechsler batteries of tests, (2) and to assess whether there was any association between CCHS characteristics and various domains of the intellectual functioning. Results There were 34 consecutive patients (15 males, 19 females) of mean (SD) age of 7.8 (3.8) years, ranging from 4 to 16 years and 6 months. Mean score of full-scale intelligence quotient was 82 (20), being in the low average range. Indexes of working memory and processing speed were significantly lower as compared to the other Wechsler indexes. There were two important findings: (1) full-scale intelligence quotient as well as indexes of verbal comprehension and processing speed were significantly greater in patients with mask ventilation than in those with tracheostomy ventilation (p = 0.012, 0.032 and 0.042 respectively); (2) most interestingly, in the patients with polyalanine repeats mutations, all intellectual indexes negatively correlated with the number of polyalanine expansion, with statistical significance reached for indexes of fluid reasoning and working memory (R = − 0.449, p = 0.032 and R = − 0.562, p = 0.012 respectively). Conclusions CCHS increased the risk to develop neurocognitive deficiencies, affecting particularly speed of processing and working memory. Our results suggested that both genetics and ventilation method could be also involved in the physiopathology of neurocognitive impairment. Further investigations were required to untangle the complex underlying processes. Neurocognitive assessments should be performed regularly in children with CCHS in order to plan re-education programs, adapt school integration and improve quality of life.