Intelligence Levels and Educational Status of Children with Meningomyelocoele

Stephen, Elspeth

doi:10.1111/j.1469-8749.1963.tb10722.x

Cited by 5 publications

(1 citation statement)

References 6 publications

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“…Until the use of a ventriculo-atrial shunt with a Spitz-Holter or Pudenz valve became general for treatment of the accompanying hydrocephalus, together with early clostu"e of the spinal defect (Eckstein and MacNab, 1966), most children with spina bifida died. Few, therefore, became mentally retarded (Stephen, 1963) or showed in comparable hospital surveys (Berg and Kirman, 1959 a and b). Of those operated in recent years about 10 per cent are likely to be severely mentally handicapped, below IQ 50 (Abbas, unpublished;Spain, 1969).…”

Section: Hydrocephalvs and Meningomyelocoelementioning

confidence: 91%

Genetic Prognosis in Severe Mental Handicap

Angeli¹,

Kìrman²

1975

J intellect Disabil Res

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Section: Hydrocephalvs and Meningomyelocoelementioning

confidence: 91%

Genetic Prognosis in Severe Mental Handicap

Angeli¹,

Kìrman²

1975

J intellect Disabil Res

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Intellectual and Perceptual-Motor Characteristics of Treated Myelomeningocele Children

Soare¹,

Raimondi²

1977

Arch Pediatr Adolesc Med

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\s=b\We studied 173 children with myelomeningocele, 133 of whom developed hydrocephalus (and had shunt procedures) and 40 of whom did not. Eighty siblings were tested as a control group. Sixty-three percent of children with hydrocephalus had IQs above 80; 87% of those without hydrocephalus had IQs above 80. Children who had associated hydrocephalus were significantly less intelligent than their siblings, whereas those without hydrocephalus were not. When patients and siblings were matched by age and IQ, the former scored significantly lower on a perceptual-motor functioning test. When patients with and without hydrocephalus were similarly matched, those with hydrocephalus scored lower. Inverse relationships between sac location and IQ, and sensory level and IQ, were found to be dependent on the association of higher sac levels and of sensory loss with hydrocephalus. Patient IQ was related to family income and education. (Am J Dis Child 131:199-204, 1977) With few exceptions,'-7 published reports of the intelligence of myelomeningocele children with (MM/H) and without (MM) hydro¬ cephalus have been limited to analyz¬ ing the natural history of nonoperatively treated hydrocephalus. By and large, these studies have been retro¬ spective, based on an accumulation of varying numbers of survivors. Simi¬ larly, the appraisals of survival, quali¬ ty of survival, and impact of the affected child on his home and enviFrom the Division of Neurological Surgery, IL 60614 (Dr Raimondi). ronment have been made from anal¬ yses of groups of children whose management has not been adequately described. METHODAs a first step in studying these children we established the criteria for diagnosing hydrocephalus in the child with myelomeningocele, determining precisely when a shunt was no longer functioning, compar¬ ing intellectual quotients with the presence or absence of hydrocephalus (treated, in the former event), using the siblings as the norm, and identifying (neuroradiologically) the nature and degree of brain dyspla¬ sia."'3 The two groups studied were myelomeningocele (MM) and shunted hy¬ drocéphalie myelomeningocele (MM/HS) children. The abbreviation MM/H refers to children who did not undergo a shunt procedure.There is, at the present time, consid¬ erable interest in the question of whether to treat such children at all, or whether treatment should be offered only to those children who may be expected to "live a meaningful life." Criteria on which such a decision may be based are lacking, though some arbitrary criteria (such as level of the myelomeningocele sac at birth, paraplegia, and hydrocephalus) have been suggested.In fact, one author has carried prediction to an extreme,' -reporting such a poor prog¬ nosis for myelomeningocele children with a thoracolumbar lesion, for example, irre¬ spective of the presence of hydrocephalus, that he recommends withholding all forms of treatment. This article presents the results of our study of the intellectual development of 173 children with myelomeningocele, 133 who had a shunt for...

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Studies on 782 Cases of Mental Deficiency Part Iv

Roboz¹,

Pitt²

1969

J Paediatrics Child Health

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Intelligence Levels and Educational Status of Children with Meningomyelocoele

Cited by 5 publications

References 6 publications

Genetic Prognosis in Severe Mental Handicap

Genetic Prognosis in Severe Mental Handicap

Intellectual and Perceptual-Motor Characteristics of Treated Myelomeningocele Children

Studies on 782 Cases of Mental Deficiency Part Iv

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