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Changes in Academic Standardized Testing After Pediatric Intensive Care
Claire C Foster1,2, Melanie Boyd3, Erin F Carlton4,5
1Department of Pediatrics, Division of Critical Care Medicine, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock.
JAMA Network Open
|April 30, 2026
Summary
Children treated in the pediatric intensive care unit (PICU) were less likely to take standardized tests post-discharge. Survivors experienced reading score declines compared to controls, highlighting cognitive health concerns after critical illness.
Area of Science:
- Pediatric Critical Care Medicine
- Neuroscience
- Public Health
Background:
- Children surviving critical illness often face long-term health issues.
- Cognitive health impacts of pediatric critical illness are not well understood due to limited pre- and post-illness assessments.
- Lack of adequate comparison groups hinders research on cognitive outcomes post-pediatric intensive care unit (PICU) admission.
Purpose of the Study:
- To evaluate cognitive health outcomes in children after pediatric intensive care unit (PICU) treatment.
- To compare academic performance of PICU-exposed children with non-PICU-exposed control students using school-based testing.
- To assess the association between PICU admission and cognitive function in children.
Main Methods:
- Retrospective case-control study utilizing statewide academic data.
- Inclusion of 1088 patients admitted to the sole PICU in Arkansas (2008-2018) and propensity score-matched controls.
- Analysis of standardized test return rates and changes in pre- to post-admission scores using logistic and linear regression.
Main Results:
- Fewer PICU patients (80.6% math, 81.1% reading) had post-admission test scores compared to controls (86.5% math, 87.1% reading).
- PICU patients exhibited below-average pre-admission scores in math and reading.
- Adjusted analyses revealed a significant decrease in reading scores (-0.07) for PICU patients relative to controls, with no significant change in math scores.
Conclusions:
- Pediatric intensive care unit (PICU) survivors are less likely to participate in standardized testing after discharge.
- PICU patients showed a greater decline in reading scores compared to matched controls.
- Further research is needed to identify risk factors for reduced testing participation and score deterioration post-PICU.
