MENTAL-DEVELOPMENT AND LEARNING-DISORDERS IN CHILDREN WITH SINGLE SUTURE CRANIOSYNOSTOSIS

Objective: This study examined the global intellectual development and presence/absence of learning disorders in children with nonsyndromic metopic, sagittal, and unilateral coronal synostosis who had early sur gery (under 1 year of age), late surgery (over 1 year of age), or no s urgery to correct the synostosis across three time periods. Design: Th e design was longitudinal. Children were assessed at initial team eval uation, 1 year after surgery or initial evaluation if surgery was not performed, and annually thereafter. Participants: Participants include d 84 consecutively evaluated patients. Seventy-two children were evalu ated at Time 1 (T1), 8 months; 57 at Time 2 (T2), 21 months; and 39 at Time 3 (T3), 50 months, Data on learning disorders or mental retardat ion were available on 34 children who were school age. Main Outcome Me asures: The Mental Development Index from the Bayley Scales of Infant Development was the main outcome measure for ii and T2, The General Co gnitive Index from the McCarthy Scales of Children's Abilities was the main outcome measure for T3, Learning disorders were determined from school and clinical records. Results: Repeated measures analyses of va riance found no statistical differences in the development of children based on diagnosis or surgical status across time. Base rate of menta l retardation at T1 was consistent with normative data; however, the i ncidence of retardation was two to three times the expected rate at T2 and T3, Learning disorders were present in 47% of schoolage children who were not retarded. Chi-square analysis showed no significant diffe rences between rates of retardation or learning disorders based on sur gical status. Conclusions: Most children with nonsyndromic craniosynos tosis obtain developmental quotients within the normal range in infanc y. Rates of retardation may increase relative to normative expectation s as children mature. A high rate of learning disorders was identified , Results are preliminary due to sample size.