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Summary:
Lo, W., A. L. Gordon, C. Hajek, A. Gomes, M. Greenham, V. Anderson, K. O. Yeates, and M. T. Mackay. “Pediatric Stroke Outcome Measure: Predictor of Multiple Impairments in Childhood Stroke.” Journal of Child Neurology 29.11 (2013): 1524-530. Web.
The purpose of this study was to examine the relationship between the scores on the pediatric stroke outcome measure (PSOM) and other functional psychometric outcomes: cognitive ability, problem behavior, adaptive behavior, and social participation. 36 stroke subjects were identified retrospectively and recruited from the Nationwide Children’s Hospital and Royal Children’s Hospital. Inclusion criteria featured 1. clinically symptomatic stroke with radiological confirmation 2. stroke occurring between birth and age 17 3. stroke occurring 1 year prior to evaluation 4. subject must be able to complete test battery. Exclusion criteria included strokes due to sickle cell disease, brain neoplasm, watershed infarcts, hydrocephalus, and genetic disorders. Subjects were then assessed with the PSOM and brain infarct volume. Furthermore, cognition and processing speed were measured with the Wechsler Abbreviated Scale of Intelligence, behavior was assessed with the Childhood Behavior Checklist, adaptive behavior was assessed with the Adaptive Behavior Assessment System II, and social participation was assessed with the Child and Adolescent Scale of Participation.
Generally, a higher total on the PSOM moderately correlated with cognitive function, behavioral problems, poorer adaptive behavior on the communication, functional academics, health & safety, and self-care sub scales, moderately to strongly correlated with Adaptive Behavior Overall, Conceptual, and Practical composite scales, and STRONGLY correlated with poor social participation. In more detail, greater impairment of the left sensorimotor, language production, and language comprehension subscales were associated with poorer Intelligence Quotient and processing speed, poorer conceptual and practical adaptive behavior, and poorer self-care adaptive behavior. Also, greater impairment on the cognitive/behavior subscale was associated with poorer outcomes in conceptual adaptive behavior and in the functional academics subdomain, but no impairment in Intelligence Quotient or problem behaviors. Finally, impaired language production and cognition was most strongly associated with poor social participation. It appears that this study contributes additional layers of information to the clinical utility of the PSOM, which can be used to help anticipate psychosocial complications in pediatric patients with stroke.