Silent cerebral infarction,income, and grade retention among students with sickle cell anemia |
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| Authors: | Allison A. King Mark J. Rodeghier Julie Ann Panepinto John J. Strouse James F. Casella Charles T. Quinn Michael M. Dowling Sharada A. Sarnaik Alexis A. Thompson Gerald M. Woods Caterina P. Minniti Rupa C. Redding‐Lallinger Melanie Kirby‐Allen Fenella J. Kirkham Robert McKinstry Michael J. Noetzel Desiree A. White Janet K. Kwiatkowski Thomas H. Howard Karen A. Kalinyak Baba Inusa Melissa M. Rhodes Mark E. Heiny Ben Fuh Jason M. Fixler Mae O. Gordon Michael R. DeBaun |
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| Affiliation: | 1. Program in Occupational Therapy and Department of Pediatrics, Hematology/Oncology, Washington University School of Medicine, St. Louis, Missouri;2. Rodeghier Consultants, Chicago, Illinois;3. Division of Hematology/Oncology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin;4. Division of Hematology/Oncology, Department of Pediatrics, Hematology/Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland;5. Division of Hematology/Oncology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio;6. Departments of Pediatrics, Neurology, and Neurotherapeutics, University of Texas Southwestern Medical School, Dallas, Texas;7. Division of Hematology/Oncology, Department of Pediatrics, Wayne State University, Detroit, Michigan;8. Division of Hematology/Oncology, Department of Pediatrics, Northwestern University, Chicago, Illinois;9. Division of Hematology/Oncology, Department of Pediatrics, University of Missouri–Kansas City, Kansas City, Missouri;10. National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland;11. Division of Hematology/Oncology, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;12. Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada;13. Neurosciences Unit, Institute of Child Health, University College London, London, United Kingdom;14. Department of Radiology, Washington University School of Medicine, St. Louis, Missouri;15. Departments of Neurology and Pediatrics, Washington University School of Medicine, St. Louis, Missouri;16. Department of Psychology, Washington University, St. Louis, Missouri;17. Division of Hematology/Oncology, Department of Pediatrics, University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania;18. Division of Hematology/Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama;19. Department of Paediatrics, Evelina Children's Hospital, St Thomas' Hospital National Health Service Trust, London, United Kingdom;20. Division of Hematology/Oncology, Department of Pediatrics, The Ohio State University, Columbus, Ohio;21. Division of Hematology/Oncology, Department of Pediatrics, Indiana University–Purdue University Indiana, Indianapolis, Indiana;22. Division of Hematology/Oncology, Department of Pediatrics, Brody School of Medicine, Greenville, North Carolina;23. Division of Hematology/Oncology, Department of Pediatrics, Sinai Hospital, Baltimore, Maryland;24. Department of Ophthalmology and Visual Sciences, Biostatistics, Washington University School of Medicine, St. Louis, Missouri;25. Vanderbilt‐Meharry Center of Excellence in Sickle Cell Disease, Division of Hematology/Oncology, Department of Pediatrics, Vanderbilt University, Nashville, Tennessee |
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| Abstract: | Children with sickle cell anemia have a higher‐than‐expected prevalence of poor educational attainment. We test two key hypotheses about educational attainment among students with sickle cell anemia, as measured by grade retention and use of special education services: (1) lower household per capita income is associated with lower educational attainment; (2) the presence of a silent cerebral infarct is associated with lower educational attainment. We conducted a multicenter, cross‐sectional study of cases from 22 U.S. sites included in the Silent Infarct Transfusion Trial. During screening, parents completed a questionnaire that included sociodemographic information and details of their child's academic status. Of 835 students, 670 were evaluable; 536 had data on all covariates and were used for analysis. The students' mean age was 9.4 years (range: 5–15) with 52.2% male; 17.5% of students were retained one grade level and 18.3% received special education services. A multiple variable logistic regression model identified that lower household per capita income (odds ratio [OR] of quartile 1 = 6.36, OR of quartile 2 = 4.7, OR of quartile 3 = 3.87; P = 0.001 for linear trend), age (OR = 1.3; P < 0.001), and male gender (OR, 2.2; P = 0.001) were associated with grade retention; silent cerebral infarct (P = 0.31) and painful episodes (P = 0.60) were not. Among students with sickle cell anemia, household per capita income is associated with grade retention, whereas the presence of a silent cerebral infarct is not. Future educational interventions will need to address both the medical and socioeconomic issues that affect students with sickle cell anemia. Am. J. Hematol. 89:E188–E192, 2014. © 2014 Wiley Periodicals, Inc. |
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