A New Method for Measuring Cognition in Children With Sagittal Craniosynostosis

Objectives: The neurocognitive profile of patients who have undergone spring-assisted surgery (SAS) for craniosynostosis is not well understood, and a variety of different cognitive measures have been used across various studies. Although neuropsychological evaluations can document cognitive strengths and weaknesses across a number of cognitive areas, they can be time consuming. This study aimed to: (1) describe the neurocognitive profile of patients who underwent SAS using both a common intelligence measure and iPad assisted testing measuring several cognitive areas, as well as parent ratings; (2) better understand the feasibility and utility of using iPad assisted assessments in this population. Methods: Thirty-six patients between the ages of 6 and 18 with sagittal synostosis who underwent SAS participated in a brief battery of assessments including a measure of abbreviated IQ, National Institutes of Health Toolbox Cognition Battery (NIH Toolbox), and caregiver ratings on the Behavior Rating Inventory of Executive Function – Second Edition (BRIEF-2). Statistical analyses assessed performance within the group and between measures. Results: Positive correlations were found between all 3 NIH Toolbox Composite scores and abbreviated IQ. Five of 7 subtests were positively correlated with Full Scale IQ, while 4 of 7 were positively correlated with both verbal and visual reasoning indices. Negative correlations between the Crystallized Composite score and BRIEF-2 were found for 8 of 9 BRIEF-2 subscales. Three of 9 BRIEF-2 subscales were negatively correlated with Fluid Composite and Total Composite scores. Conclusions: Cognitive data were generally aligned with the normal distribution curve. Although caregiver ratings yielded several executive functioning concerns, significant correlations were found with composite scores and a few specific subtests. Use of the NIH Toolbox was feasible in this population and shows promise as a tool for measuring a range of different cognitive domains.