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Processing speed and academic fluency in youth with sickle cell disease

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source: American Society of Pediatric Hematology/Oncology

year: 2017

authors: Molly Gardner, Sarah Bills, Katie Olson, Kristina Hardy, Steven J. Hardy


Children with sickle cell disease (SCD) are at risk for global neurocognitive deficits. Even in youth with SCD who have not endured a stroke, subtle white matter changes are common and can disrupt specific functions such as cognitive efficiency. However, processing speed deficits in SCD and their relation to academic outcomes and perceptions of academic success have not been systematically investigated.

To measure processing speed and explore associations with academic fluency, academic achievement, and children’s self-perception of scholastic competence.

Participants’ standard scores on measures of processing speed were lower than expected compared to the normative sample (M=88.13-94.91). In regards to academic tasks, children exhibited the greatest difficulty in math fluency (M=83.17, SD=13.58). Processing speed predicted performance on both reading and math fluency tasks (β=0.60, and β=0.52 respectively, p0<.001). Academic fluency predicted children’s perceptions of scholastic competence (β=0.47, p=0.013). A regressing model including processing speed and academic fluency predicted 22% of the variance in parent-reported school performance (p=0.003). Youth who repeated a grade (n=6) scored lower on processing speed and academic fluency tasks compared to youth who did not repeat a grade (Processing Speed Index median=68.5 and 82.0, respectively; Academic Fluency median=68.5 and 82.0, respectively).

Youth with SCD scored in the Low-Average to Average range on measures of processing speed, representing a generalized weakness in quickly and efficiently processing information. This weakness appears to negatively impact academic performance, particularly in regards to math fluency. Such problems affect children’s sense of scholastic competence and were associated with poorer academic achievement, as reported by parents. Furthermore, slowed processing was associated with a greater incidence of grade retention in this population. Results have implications for the identification of youth with SCD at risk for academic difficulties and the development of interventions to promote positive academic outcomes.

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