Limited data suggest that adolescents with multiple sclerosis (MS) frequently discontinue school. While it is known that cognitive impairment occurs in 30% to 50% of children with MS, the functional impact of childhood MS on academic achievement is virtually unknown.
Objective:
To that end, this paper builds an evidence-based argument for evaluating educational outcomes in children with MS.
Methods:
This will be accomplished through (a) a review of pediatric MS and its cognitive consequences; (b) a selective review of the utility of neuropsychological batteries in assessing academic outcomes in pediatric populations in general; and (c) a brief overview of modifiable factors that have a potential benefit on school outcomes in children with MS.
Conclusion:
Scholastic achievement should be assessed as part of the routine cognitive screening of children and adolescents with MS.
SikesEMMotlRWNessJM. Pediatric multiple sclerosis: Current perspectives on health behaviors. Pediatric Health Med Ther2018; 9: 17–25.
2.
JulianLSerafinDCharvetL, et al. Cognitive impairment occurs in children and adolescents with multiple sclerosis: Results from a United States network. J Child Neurol2013; 28(1): 102–107.
3.
JulianLJVellaLVollmerT, et al. Employment in multiple sclerosis: Exiting and re-entering the work force. J Neurol2008; 255(9): 1354–1360.
4.
SmithMMArnettPA. Factors related to employment status changes in individuals with multiple sclerosis. Mult Scler2005; 11(5): 602–609.
5.
StaplesDLincolnNB. Intellectual impairment in multiple sclerosis and its relation to functional abilities. Rheumatol Rehabil1979; 18(3): 153–160.
6.
MarcotteTDRosenthalTJRobertsE, et al. The contribution of cognition and spasticity to driving performance in multiple sclerosis. Arch Phys Med Rehabil2008; 89(9): 1753–1758.
7.
AmatoMPGorettiBGhezziA, et al. Cognitive and psychosocial features in childhood and juvenile MS: Two-year follow-up. Neurology2010; 75(13): 1134–1140.
8.
AmatoMPGorettiBGhezziA, et al. Neuropsychological features in childhood and juvenile multiple sclerosis: Five-year follow-up. Neurology2014; 83(16): 1432–1438.
9.
TillCRacineNAraujoD, et al. Changes in cognitive performance over a 1-year period in children and adolescents with multiple sclerosis. Neuropsychology2013; 27(2): 210–219.
10.
TillCGhassemiRAubert-BrocheB, et al. MRI correlates of cognitive impairment in childhood-onset multiple sclerosis. Neuropsychology2011; 25(3): 319–332.
11.
GroverSASyeAAubert-BrocheB, et al. Young adults with pediatric-onset MS have a downward educational trajectory. Mult Scler J2014; 20: 394.
12.
MacAllisterWSBelmanALMilazzoM, et al. Cognitive functioning in children and adolescents with multiple sclerosis. Neurology2005; 64(8): 1422–1425.
13.
KuhGKinzieJBuckleyJA. What matters to student success: A review of the literature commissioned report for the national symposium on postsecondary student success: Spearheading a dialog on student success. Washington, DC: National Postsecondary Education Cooperative. 2006.
14.
YorkTGibsonCRankinS. Defining and measuring academic success. Pract Asses Res Eval2015; 20(5): 1–20.
15.
La SalleTRoachAMcGrathD. The relationship of IEP quality to curricular access and academic achievement for students with disabilities. Int J Special Educ2013; 28(1): 135–144.
BeattyWWBlancoCRWilbanksSL, et al. Demographic, clinical, and cognitive characteristics of multiple sclerosis patients who continue to work. J Neurol Rehab1995; 9(3): 167–173.
18.
MorrowSADrakeAZivadinovR, et al. Predicting loss of employment over three years in multiple sclerosis: Clinically meaningful cognitive decline. Clin Neuropsychol2010; 24(7): 1131–1145.
19.
McCallRB. Childhood IQ’s as predictors of adult educational and occupational status. Science1977; 197(4302): 482–483.
20.
GanesalingamKYeatesKOTaylorHG, et al. Executive functions and social competence in young children 6 months following traumatic brain injury. Neuropsychology2011; 25(4): 466–476.
21.
PriceKJJoschkoMKernsK. The ecological validity of pediatric neuropsychological tests of attention. Clin Neuropsychol2003; 17(2): 170–181.
22.
MitchellWGChavezJMLeeH, et al. Academic underachievement in children with epilepsy. J Child Neurol1991; 6(1): 65–72.
23.
ParrishJBWeinstock-GuttmanBSmerbeckA, et al. Fatigue and depression in children with demyelinating disorders. J Child Neurol2013; 28(6): 713–718.
24.
GorettiBPortaccioEGhezziA, et al. Fatigue and its relationships with cognitive functioning and depression in paediatric multiple sclerosis. Mult Scler2012; 18(3): 329–334.
25.
MacAllisterWSBoydJRHollandNJ, et al. The psychosocial consequences of pediatric multiple sclerosis. Neurology2007; 68(16 Suppl. 2): S66–S69.
26.
ZafarABNessJDowdyS, et al. Examining sleep, fatigue, and daytime sleepiness in pediatric multiple sclerosis patients. Mult Scler2012; 18(4): 481–488.
27.
CarrollSChalderTHemingwayC, et al. “It feels like wearing a giant sandbag.” Adolescent and parent perceptions of fatigue in paediatric multiple sclerosis. Eur J Paediatr Neurol2016; 20(6): 938–945.
28.
GroverSAAubert-BrocheBFetcoD, et al. Lower physical activity is associated with higher disease burden in pediatric multiple sclerosis. Neurology2015; 85(19): 1663–1669.
29.
GroverSASawickiCPKinnett-HopkinsD, et al. Physical activity and its correlates in youth with multiple sclerosis. J Pediatr2016; 179: 197–203.
30.
Kinnett-HopkinsDGroverSAYehEA, et al. Physical activity in pediatric onset multiple sclerosis: validating a questionnaire for clinical practice and research. Mult Scler Relat Disord2016; 10: 26–29.
31.
SchrankF. Using the Woodcock-Johnson III with individuals with ADHD. The ADHD Report2005; 13(5): 9–11.
32.
Abu-HamourBAl HmouzHMattarJ, et al. The use of Woodcock-Johnson tests for identifying students with special needs-a comprehensive literature review. Proc Soc Behav Sci2012; 47: 665–673.
