Sickle Cell Disease Clinical Trial
Official title:
Working Memory and School Readiness in Preschool-Aged Children With Sickle Cell Disease: Family and Environmental Factors
Children with sickle cell disease (SCD) are at risk for neurobehavioral problems because of
the impact the disease can have on the central nervous system. Specific impairments in
working memory are particularly prevalent in school-aged children with SCD. Working memory is
more strongly associated with school readiness and academic success than intellectual ability
in the general population. The adverse effects of low socioeconomic status (SES) and poverty
on cognition and neurodevelopment emerge early, before children have entered formal
education. In addition, they affect language and executive function skills (e.g., working
memory) more than other skills. SES is a proxy variable for other risk factors. Higher SES is
associated with less parental stress, more supportive parenting practices, and better
cognitive stimulation based on the availability of books, computers, and outings.
PRIMARY OBJECTIVE:
- To examine working memory and school readiness in young children with sickle cell
disease in comparison to demographically matched control children without sickle cell
disease.
SECONDARY OBJECTIVE:
- To examine the relationships of family/environmental factors (caregiver stress, parental
responsiveness, and cognitive stimulation in the home) and disease severity to working
memory and school readiness skills in preschool-aged children with SCD.
Participants will be recruited through the Pediatric Sickle Cell Clinic at St. Jude. All
participants with SCD will be evaluated once with laboratory measures of cognitive and
pre-academic skills and parent questionnaires. Medical history will be evaluated for purposes
of characterizing the health status and disease severity of patients and determining how
medical factors are related to school readiness and working memory in SCD population. The
study expects to accrue up to 99 participants with SCD.
Demographically-matched control children will be selected from a database of participants
enrolled in an ongoing longitudinal study of neurocognitive development in children born in
Shelby County, Tennessee. The control group will be randomly selected from an existing study
group and will not be enrolled on the MEMREAD protocol. Control group participants will be
excluded if they have any sensory or motor impairment that would preclude valid testing
(e.g., blindness, paresis), or if they have received treatment with non-stimulant
psychotropic medication. A de-identified data file that includes the following results for up
to 168 demographically-matched healthy control participants (approximately 1:2 ratio of SCD
to healthy control) will be provided for control comparison purposes:
- Health Evaluation (CV4)
- Stanford binet - Fifth Edition (CV4)
- Bracken Basic Concepts Scale - Third Edition (CV4)
- The Behavior Rating Inventory of Executive Function - Preschool Version (BRIEF-P) (CV4)
- The Scales of Independent Behavior - Revised, Early Development Form (SIB-R) (CV4)
- Demographics (CV4)
- Additional Covariates (if any) including gestational age at birth, developmental delays,
major medical illnesses, surgery history, neurological event history, pre-kindergarten
attendance, and daycare attendance
;
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