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Iodine deficiency, the most common cause of preventable mental impairment worldwide, has been linked to poorer intellectual function in several studies. However, to our knowledge, no studies have been performed in moderate iodine-deficient schoolchildren using the complete form of Wechsler Intelligence Scale for Children (WISC-III; Portuguese version). The main purpose of this study was to ascertain whether moderate iodine deficiency would affect the cognitive function of schoolchildren (7–11 years old; 3rd and 4th grades). Raven’s Colored Progressive Matrices (CPM; Portuguese version) were used for measuring the intelligence quotient (IQ) of the total population (n = 256; median UIC = 66.2 μg/L), and the WISC-III was used to study two selected subgroups: one moderately iodine-deficient (n = 30) and the other with adequate iodine intake (n = 30). WISC-III was shown to be the prime instrument for cognitive function assessment among moderate iodine-deficient schoolchildren; this subgroup had a Full-Scale IQ 15.13 points lower than the adequate iodine intake subgroup, with a magnitude effect of d = 0.7 (p = 0.013). Significant differences were also registered in 6 of the 13 Verbal-Performance IQ subtests. Moderate iodine deficiency has a substantial impact on mental development and cognitive functioning of schoolchildren, with significant impairment in both Performance IQ and Verbal IQ spectrum, adversely impacting their educational performance.

Background: Several epidemiologic studies have demonstrated relationships between prenatal exposure to polychlorinated biphenyls (PCBs) and modest cognitive impairments in infancy and early childhood. However, few studies have followed cohorts of exposed children long enough to examine the possible impact of prenatal PCB exposure on psychometric intelligence in later childhood. Of the few studies that have done so, one in the Great Lakes region of the United States reported impaired IQ in children prenatally exposed to PCBs, whereas another found no association. Objectives: This study was designed to determine whether environmental exposure to PCBs predicts lower IQ in school-age children in the Great Lakes region of the northeastern United States. Methods: We measured prenatal exposure to PCBs and IQ at 9 years of age in 156 subjects from Oswego, New York. We also measured > 50 potential predictors of intelligence in children, including repeated measures of the home environment [Home Observation for Measurement of the Environment (HOME)], socioeconomic status (SES), parental IQ, alcohol/cigarette use, neonatal risk factors, and nutrition. Results: For each 1-ng/g (wet weight) increase in PCBs in placental tissue, Full Scale IQ dropped by three points (p = 0.02), and Verbal IQ dropped by four points (p = 0.003). The median PCB level was 1.50 ng/g, with a lower quartile of 1.00 ng/g and an upper quartile of 2.06 ng/g. Moreover, this association was significant after controlling for many potential confounders, including prenatal exposure to methylmercury, dichlorodiphenyldichloroethylene, hexachlorobenzene, and lead. Conclusions: These results, in combination with similar results obtained from a similar study in the Great Lakes conducted 10 years earlier, indicate that prenatal PCB exposure in the Great Lakes region is associated with lower IQ in children.

The French adaptation of the Wechsler Intelligence Scale of Children, 5th edition (WISC-V) was an opportunity to examine if some common representations of gender differences in intellectual abilities are supported by empirical evidence. The WISC-V standardization sample provided data on a wide range of cognitive tests in a large sample of 6- to 16-year-old children representative of the French population. This sample included 517 boys and 532 girls. The WISC-V data were compared to those of the French standardization samples of three previous versions of the WISC (WISC-R, WISC-III, and WISC-IV). These four standardization samples span a 35-year period. The data analysis of the WISC-V standardization sample and the three previous versions of this intelligence scale showed that the performance gaps on intellectual tests between girls and boys have gradually narrowed over time. Almost no gender differences were observed in the WISC-V standardization sample, not only in IQ but also in key facets of intelligence. Data do not support the stereotype that girls are better at verbal tasks and boys are better at visuospatial tasks. However, some statistically significant differences remain, but the magnitude was generally small with no practical implications. The only important difference is in favor of girls and concerns performance on processing speed tasks that require visual discrimination, attentional control, and writing.

Objectives: To determine the prevalence of cognitive delay and possible associated dysmorphic features in children exposed to antiepileptic drugs (AEDs) in utero. Design: Retrospective study of children born to mothers with epilepsy. Setting: Regional epilepsy clinics in Liverpool and Manchester, UK. Participants: Children aged between 6 months and 16 years born to mothers with epilepsy. Main outcome measures: Structured interviews, hospital records, clinical examination, and psychometric tests (Wechsler) were used to assess exposure and intelligence quotient (IQ). Blinded assessment of photographs was used to score children with characteristic dysmorphic features. Results: A total of 249 children aged 6 and over were studied: 41 were exposed to sodium valproate, 52 to carbamazepine, 21 to phenytoin, 49 to polytherapy, and 80 were unexposed. Mean verbal IQ was significantly lower in the valproate group compared to unexposed and other monotherapy groups. Multiple regression analysis showed that both valproate exposure and frequent tonic-clonic seizures in pregnancy were significantly associated with a lower verbal IQ despite adjusting for other confounding factors. There was a significant negative correlation between dysmorphic features and verbal IQ in children exposed to valproate. Conclusions: This study identifies valproate as a drug carrying potential risks for developmental delay and cognitive impairment and is the first to suggest that frequent tonic-clonic seizures have a similar effect. Our results need to be interpreted with caution given their retrospective nature. Women with epilepsy need careful counselling about individual risk benefit of AED treatment before pregnancy.

Background and Objectives: Late long-term outcomes of perinatal asphyxia (PA) in school-age are often unclear. To assess long-term outcomes at an early school age in children who had experienced perinatal hypoxia or asphyxia, where therapeutic hypothermia was not applied. Materials and Methods: The case group children were 8–9-year-old children (n = 32) who were born at full term and experienced hypoxia or asphyxia at birth, where therapeutic hypothermia (TH) was not applied. The control group consisted of 8–9-year-old children (n = 16) born without hypoxia. A structured neurological examination was performed at an early school age. The neuromotor function was assessed using the Gross Motor Function Classification System (GMFCS). Health-related quality-of-life was assessed using the Health Utilities Index (HUI) questionnaire. Intellectual abilities were assessed using the Wechsler Intelligence Scale for Children (WISC). Results: The case group, compared with controls, had significantly (p = 0.002) lower mean [SD] full-scale IQ (87(16.86) vs. 107(12.15)), verbal-scale IQ (89(17.45) vs. 105(11.55)), verbal comprehension index (89(17.36) vs. 105(10.74)), working memory index (89(15.68) vs. 104(11.84)), performance IQ (87(16.51) vs. 108(15.48)) and perceptual organization index (85(15.71) vs. 105(15.93)). We did not find any significant differences in the incidence of disorders of neurological examination, movement abilities and health-related quality of life at an early school age between the case and the control group children. Conclusion: In children who experienced perinatal asphyxia but did not have cerebral paralysis (CP), where therapeutic hypothermia was not applied, cognitive assessment scores at an early school age were significantly lower compared to those in the group of healthy children, and were at a low average level.

Objective: To examine the contributions of injury severity, physical and cognitive disability, child and family function to outcome 30 months after traumatic brain injury (TBI) in children. Design: A prospective, longitudinal, between group design, comparing function before and after injury across three levels of injury severity. Subjects: One hundred and fifty children, 3.0–12.11 years old, admitted to hospital with a diagnosis of TBI. The sample was divided according to injury severity: mild (n = 42), moderate (n = 70), severe (n = 38). Children with a history of neurological, developmental, and psychiatric disorders were excluded from participation. Main outcome measures: Post injury physical function, cognitive ability (incorporating intellect, memory, and attention), behavioural and family functioning, and level of family burden. Results: A dose–response relation was identified for injury severity and physical and cognitive outcome, with significant recovery documented from acute to six months after TBI. Behavioural functioning was not related to injury severity, and where problems were identified, little recovery was noted over time. Family functioning remained unchanged from preinjury to post injury assessments. The level of family burden was high at both six and 30 months after injury, and was predicted by injury severity, functional impairment, and post injury child behavioural disturbance. Conclusions: These results suggest ongoing problems for the child and significant family burden 30 months after TBI. The nature and severity of the physical and cognitive problems are closely related to injury severity, with child and family function predicted by psychosocial and premorbid factors.

Spina bifida is a multifaceted neurological condition with complex neuropsychological sequelae. The cognitive outcome in spina bifida has frequently been attributed to the severity of the hydrocephalus. However, because of complex neuropathology, the influence of hydrocephalus alone does not sufficiently explain the deficits in the cognitive profile in spina bifida. To date, little is known of the role of Arnold-Chiari-II malformation (ACM) in the cognitive profile of these patients. Aim of the current study is to delineate the specific contribution of the ACM in spina bifida by comparing children with ACM and those without ACM. 46 children between 6 and 15 years of age underwent a neuropsychological assessment covering intelligence and a wide range of cognitive functions, such as visuo-motor processing, attention, memory, word fluency and speed of information processing. Comparisons were made between patients with ACM (ACM+) and those without ACM (ACM−); all children with ACM+ also had hydrocephalus. Confounding effects of global cognitive impairment were excluded, such that groups were matched on verbal IQ. Because of complex neuropathology, which is inherent to spina bifida, the method applied was based on a comparison of cognitive profiles of the study group with profiles of patients with cerebellar damage and hydrocephalus found in the literature. Impaired visual analysis and synthesis, verbal memory, and verbal fluency, even after correction for global cognitive impairment, were observed in children with ACM. The hypothesis that in addition to impairment in visual analysis and synthesis, which are related to both hydrocephalus and ACM, specific deficiencies in verbal memory and fluency may be attributed to ACM is supported.

Background Children with learning disabilities are a heterogeneous group of children with a common characteristic discrepancy on the progress and development of their individual learning abilities. A few statistical analyses have been published regarding the factor analysis of the Greek Edition of Wechsler Intelligence Scale for Children-III. The aim of the research is the emergence of a new factorial model which describes the General Intelligence (g) of children and adolescents with learning disabilities, and that differs from the already existing intelligence models. This study aims to compare three-factor structure models of WISC-III in children with learning disabilities in the Greek population. Methods A sample of 50 children were selected on the basis of research criteria from a total of 122 children who evaluated in a child psychiatric service in a general hospital, in a residential area in Greece. The Wechsler Intelligence Scale for Children—Third Edition was used to assess children’s cognitive function. Using multi-factor analysis, three alternative factor models were compared. Results Analysis of factor structure models suggests a new bi-factorial model that more appropriately describes the areas of cognitive development of children with learning disabilities. The first factor includes Comprehension, Picture Arrangement, Coding, Block Design, and Object Assembly, whereas the second one combines Information, Similarities, Arithmetic, Vocabulary, and Picture Arrangement. Conclusions The present study shows the existence of a factorial model with two factors: one aggregating the Comprehension verbal subtest with four performance subtests and the other the Picture Arrangement performance subtest with four verbal subtests. This two-factor model includes the loadings in two factors that relate to sequencing abilities and verbal reasoning abilities of children. These findings assert the clinical utility of the intelligence evaluation in the specific population.

In all psychological tests, scoring should be of concern for examiners because the accuracy of results depends, at some extent, on the quality of the correction. This work aims to examine the correction, by different psychologists, of the scores for the Wechsler Intelligence Scale for Children (WISC-III) subtests of Similarities, Vocabulary and Comprehension since these are the subtests where examiner's subjectivity seemingly most influences scoring. Forty two psychologists from different states in Brazil participated in this study. They corrected the answers of six test protocols randomly selected from a standardization sample for the Brazilian context. Taking as reference the total scores, the Vocabulary subtest showed greater variability in score, followed by the Comprehension one. Considering the total number of items tested in each subtest, Similarities had the highest agreement among raters. The results showed that all the three subtests involve subjectivity on behalf of the examiner to score the answers. Continuing in this study, we also aim to determine test reliability based on interrater agreement. Keywords: WISC-III; Psychometric; Verbal Subtests. Este trabalho visou analisar a pontuacao dos subtestes Semelhancas, Vocabulario e Compreensao do WISC-III, tendo em vista que podem envolver maior subjetividade do avaliador. Participaram do estudo 42 psicologos de diferentes Estados do Brasil, os quais corrigiram as respostas de 6 protocolos do teste selecionados aleatoriamente da amostra de padronizacao ao contexto brasileiro. Tomando-se como referencia os escores totais, o subteste Vocabulario apresentou maior variabilidade nas pontuacoes, seguido por Compreensao. Considerando-se o total de itens analisados em cada subteste, Semelhancas apresentou a maior concordancia entre os avaliadores. Entretanto, os resultados evidenciaram que os tres subtestes envolvem a subjetividade do avaliador na pontuacao das respostas. Palavras-chave: WISC-III; Psicometria; Subtestes Verbais.