Cognitive Functioning and Educational Support Plans in Youth With Sickle Cell Disease

Area of Science:

• Pediatric Hematology
• Neuropsychology
• Educational Psychology

Background:

• Children with sickle cell disease (SCD) experience academic difficulties due to disease-related factors.
• Educational support plans, such as 504 Plans or Individualized Education Programs (IEPs), aim to mitigate these challenges.
• Understanding the relationship between cognitive function and access to these plans is crucial for equitable support.

Purpose of the Study:

• To determine the proportion of youth with SCD who have educational support plans.
• To investigate the association between cognitive functioning (overall intelligence, processing speed, working memory) and executive functioning with the presence of these plans.

Main Methods:

• Ninety-one youth (7-16 years) with SCD were assessed using the Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V).
• Caregivers reported on the presence of educational support (504 Plan/IEP) and completed the Behavior Rating Inventory of Executive Function.
• Statistical analyses (chi-square, t-tests) examined relationships between cognitive/executive function and educational plans.

Main Results:

• 42% of youth with SCD in the sample did not have an educational support plan, despite eligibility.
• Lower full-scale intelligence quotient (FSIQ < 90) was associated with a higher likelihood of having a plan (74% vs. 47%).
• Deficits in processing speed and parent-reported executive functioning were significantly linked to educational support.

Conclusions:

• Significant cognitive and executive functioning deficits correlate with educational plan receipt in youth with SCD.
• A notable proportion of children with SCD do not receive needed educational support.
• Subtle cognitive deficits may lead to underidentification for essential academic accommodations.