Psychosocial adjustment and physical growth in children with imperforate anus or abdominal wall defects
M E Ginn-Pease1, D R King, K J Tarnowski
1Department of Surgery, Ohio State University College of Medicine, Children's Hospital, Columbus 43205.
Insights
Children with imperforate anus (IA) and abdominal wall defects (AWDs) often experience learning disabilities and behavioral issues. Routine screening for these conditions is recommended for better long-term outcomes.
Area of Science:
- Pediatric Surgery
- Developmental Psychology
- Child Health
Background:
- Pediatric surgeons aim for lifelong function in patients with congenital anomalies.
- Anatomical success does not always guarantee optimal functional outcomes.
- Imperforate anus (IA) and abdominal wall defects (AWDs) require long-term patient management.
Purpose of the Study:
- To evaluate the academic achievement and psychosocial status of children with IA and AWDs.
- To identify potential learning disabilities and behavioral problems in this cohort.
- To inform clinical practice regarding comprehensive patient assessment.
Main Methods:
- Psychological testing instruments were used to assess 56 children (mean age 10.6 years).
- Academic achievement (reading, math) and psychosocial status were evaluated.
- Physical growth and clinical status were assessed via anthropometrics and parent questionnaires.
Main Results:
- Children exhibited average intellectual ability and normal academic achievement as a group.
- Specific learning disabilities were noted in 12.5% (reading) and 10.7% (math).
- Significant percentages showed externalizing (25%) and internalizing (29%) behavior disorders, and social competency deficits (23%).
Conclusions:
- Children with IA and AWDs are at risk for learning disabilities and behavioral challenges.
- No significant differences were found between IA and AWD patient groups.
- Routine screening for learning and behavioral issues is crucial for this pediatric population.
Abstract:
Pediatric surgeons have the unique responsibility of performing surgical procedures that will enable their patients to function normally throughout a lifetime. Good anatomic results may not ensure that this goal will be achieved. Using a battery of psychological testing instruments, we evaluated the academic achievement and psychosocial status of 56 children (mean age, 10.6 years) with imperforate anus (IA) and abdominal wall defects (AWDs). Physical growth was assessed by measurement of standard anthropometric parameters, and a parent questionnaire was used to define clinical status. As a group, the children presented with average intellectual ability. Achievement in both reading and math was in the normal range. In 12.5% of the children a reading learning disability was noted and 10.7% had a disability in math. On the basis of parental assessments, 25% of the children demonstrated externalizing behavior disorders (eg, conduct problems) and 29% displayed internalizing symptomatology (eg. withdrawal, anxiety). Social competency deficits were described in 23% of the children. Data obtained from the teachers were consistent with the parental assessments. No major differences between the IA and AWD patients in academic achievement, psychosocial status, or physical growth were discovered. Routine screening of these children for learning disabilities and behavior problems is recommended.
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