Volume 28, Issue 2 (1999)
The Impact of Sickle Cell Disease on Cognitive Functioning and Learning
Melanie J. Bonner, Kathryn E. Gustafson, Elizabeth Schmacher, Robert T. Thompson, Jr.
Abstract- Sickle Cell Disease (SCD) refers to a complex group of hereditary hematologic disorders that are most common in people of African descent (Sickle Cell Disease Guideline Panel,1 993). Although most children with SCD demonstrate adequate academic functioning, some children experience neurological insults such as strokes that can negatively affect school performance. Even in the absence of overt neurological disease, SCD puts some children at risk for neuropsychological sequelae including lowered intellectual functioning, academic skills deficits, impaired fine-motor functioning, and attentional deficits. Studies that document these deficits have evolved from descriptive summaries to more methodologically sound investigations of neuropsychological deficits with corresponding neuroradiographic findings. These studies will be reviewed to highlight the sometimes subtle and complex neuropsychological impairments found in some children with SCD. This review also will demonstrate the importance of careful monitoring and assessment of all children with SCD to facilitate early identification of that subset of children with neuropsychological sequelae. Additionally, possible indirect effects of SCD that can negatively impact school performance will be highlighted including absenteeism, psychological functioning, and pain coping. Finally, recommendations for school programming are offered to facilitate an optimal learning environment for school children with SCD.
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