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Routine Screening for Neurocognitive Impairment in Patients with Craniosynostosis: Towards a Standardized Approach
Payton K Grande1, Christen M Holder2, Billy D Holcombe3,4
1University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA.
Insights
Craniosynostosis impacts neurocognitive development, but standardized screening is lacking. This study recommends free, low-cost tools for early detection of developmental risks in affected children.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatric Medicine
Background:
- Craniosynostosis, a birth defect, poses significant risks to neurocognitive development beyond cosmetic concerns.
- Current screening methods for identifying at-risk patients are not standardized, creating a critical gap in care.
- Early identification of neurocognitive and psychosocial challenges is crucial for timely intervention.
Purpose of the Study:
- To identify and recommend standardized, accessible screening instruments for neurocognitive development in patients with craniosynostosis.
- To propose a routine clinical approach utilizing free or low-cost screening tools.
- To facilitate early detection of potential adverse neuropsychosocial outcomes.
Main Methods:
- A systematic literature review was conducted to identify relevant neurocognitive assessments.
- Data from 114 cited tests were extracted and analyzed.
- Two trained neuropsychologists reviewed, categorized, and recommended screening instruments.
Main Results:
- Six key areas for routine screening were identified: Development, Social-Emotional/Behavioral, Adaptive Functioning, Academic Achievement, Autism, and ADHD/Attention.
- Specific free or low-cost screening instruments were recommended within each category.
- The recommended tools are easily administered in a clinical setting, with or without a trained examiner.
Conclusions:
- Craniosynostosis significantly impacts neuropsychosocial development, necessitating early and routine screening.
- The recommended screening approach is cost-effective, age-adaptable, and clinically feasible.
- This study provides a foundation for standardized neurocognitive evaluation in craniosynostosis patients, improving care and outcomes.
Abstract:
ObjectiveBeyond aesthetic implications, craniosynostosis can profoundly impact neurocognitive development. There is a notable gap in standardized methodologies for identifying which of these patients are at-risk for developing adverse neuropsychosocial outcomes through screening techniques. This research aims to identify and recommend a standardized, routine approach inclusive of free or low-cost screening instruments for patients with craniosynostosis that are easily administered in clinic with or without a trained examiner.DesignA systematic review was conducted. Data related to various developmental assessments were extracted and subsequently reviewed by two trained neuropsychologists for analysis, categorization, and recommendation.Main Outcomes MeasuresNeurocognitive screening assessments for patients with craniosynostosis.ResultsIn total, 114 different tests regarding neurocognitive examination of patients with craniosynostosis were cited. We identified six areas of neuropsychosocial development that are relevant for routine screening: Development, Social-Emotional/Behavioral, Adaptive Functioning, Academic Achievement, Autism, and ADHD/Attention. Within each category, screening recommendations are made, including instruments that are free or low-cost and can be easily administered in clinic with or without a trained examiner.ConclusionsLiterature supports the impact of craniosynostosis on neuropsychosocial development, so we urge teams to screen patients from an early age using these suggestions as they are free or relatively low-cost, can be administered to a wide range of patient ages, and can be administered in clinic with or without a trained examiner. This study serves as a starting point towards a more standardized approach to effectively evaluate and address the neurocognitive implications of craniosynostosis, ultimately enhancing patient care and treatment outcomes.
