Document Type
Article
Abstract
Aim
To assess the predictive validity of neurodevelopmental screening in toddlers and preschool children with sickle cell disease (SCD) using the Ages and Stages Questionnaire (ASQ). We expected screening in preschool children to predict academic problems in elementary school and future stroke risk.
Method
Using a longitudinal cohort design, academic problems (e.g. grade retention, failing a subject) and increases in stroke risk (e.g. abnormal transcranial Doppler exam) were assessed for a 6-year period after neurodevelopmental screening in 2-year-olds (‘toddlers’) and 4-year-olds (‘preschool children’) using medical record review, which included annual information from parents about school functioning. Biopsychosocial variables were examined as alternate predictors.
Results
In total, 30% of toddlers and 34% of preschool children had positive screenings. For toddlers (n = 111), positive screenings on the ASQ predicted academic problems (p = 0.009), but not increased stroke risk (p = 0.938). For preschool children (n = 110), positive screenings predicted academic problems (p < 0.001) and increased stroke risk (p = 0.018). The ASQ independently predicted academic outcomes across cohorts; baseline biomedical factors were unique predictors of stroke across cohorts.
Interpretation
Screening with the ASQ allows for risk stratification for neurodevelopmental outcomes in SCD. Screening in preschool children is important because of changing risk factors with age.
Digital Object Identifier (DOI)
Publication Info
Published in Developmental Medicine & Child Neurology, 2025.
Rights
© 2025 The Author(s). Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
APA Citation
Bills, S. E., Schatz, J., Gillooly, E., Johnston, J. D., Waters, A. L., & Schlenz, A. M. (2025). Academic and cerebrovascular outcomes after neurodevelopmental screening in sickle cell disease: A longitudinal cohort study. Developmental Medicine & Child Neurology.https://doi.org/10.1111/dmcn.70078