P~ceptzdaland Mot07 Skills, 1977,44, 381-382. @ Perceptual and Motor Skills 1977
SPINA BIFIDA CHILDREN'S SCORES ON THE WECHSLER INTELLIGENCE SCALE FOR CHILDREN1 BRIAN TEW IVehh National School of Medicine Summary.-An analysis of the scores of 58 cases assessed on the WISC suggested there was a differential intellectual prognosis according to type of lesion, the presence of hydrocephalus, degree of physical disability and sex, with girls having the poorer outcome. Spina bifida refers to three types of spinal lesion. These include ( 1 ) Meningocele, representing 5% of all cases; such children generally have a good physical prognosis. ( 2 ) Encephalocele also accounts for 5 % of all cases; these may have sensory defects, as well as spasticity, notably where brain tissue has been removed in repairing the lesion. The remainder are of ( 3 ) Myelomeningocele, the most serious manifestation of spina bifida, having a high mortality rare. More than 80% of children with this lesion also have hydrocephalus, which generally requires further neurosurgery. Between 1956 and 1962, 425 cases of spina bifida were ascertained in a defined area of South Wales. As few children had early surgery, this sample represented, as near as was possible, the narural history of the condition. In 1971, 59 children survived, with a mean age of 11.6 yr.; 32 were myelomeningoceles, 17 meningoceles, and 9 were encephaloceles. There were 34 boys and 24 girls; one child was untraced. On the Wechsler Intelligence Scale for Children this sample earned a mean Verbal 1Q of 89.1 (SD, 21.6), a Performance Scale I Q of 82.3 (SD, 22.6), and a Full Scale IQ of 84.5 (SD, 22.9). According to the qpe of lesion, for the meningoceles mean IQs were 95.0 on the Verbal Scale (SD, 15.8), 93.3 on the Performance Scale ( S D , 12.6). and 93.8 ( S D , 13.4) on the Full Scale. N o case scored under 70. Myelomeningoceles were not significantly lower. Their Verbal IQ was 94.1 ( S D , 20.5), Performance I Q 84.7 ( S D , 19.0), and Full Scale I Q 88.8 ( S D , 18.2). IQs were 70 for 16% but 22% had IQs h 100. Encephaloceles had lower IQs ( P < .001) than children with other kinds of lesion who earned a mean Verbal Scale I Q of 60.9 (SD, 21.0), a Performance Scale IQ of 52.3 ( S D , 22.4), and a Full Scale IQ of 51.9 ( S D , 22.7). Girls had lower IQs ( P < .001) than boys. The mean Verbal Scale IQ of the girls was 77.2 (SD, 20.4), the Performance I Q 70.1 ( S D , 21.4) and the Full Scale 71.3 (SD, 21.9), while the mean Verbal Scale I Q of the boys was 96.9 ( S D , 18.9), the Performance IQ 90.3 ( S D , 19.9) and the Full Scale 93.2 ( S D , 19.3). N o meningoceles had hydrocephalus and a few cases of encephalocele and myelomeningocele also escaped this complication. They had a mean Full Scale I Q of 93.3. Among the remainder, hydrocephalus was divided into three grades: mild hydrocephalus ( 1 2 cases) corresponded to a cerebral mantle thickness of t 4 cm. Their Full Scale IQ was 87.7. Moderate hydrocephalus ( 1 0 cases) had a mantle thidrness between 2 and 4 cm. Their Full Scale IQ was 77.7, and the severe hydrocephalics ( 8 cases) had a mantle thickness 2 cm. Their Full Scale IQ was 57.6. In the cases with known hydrocephalus, the mean Performance I Q was not significantly lower than verbal skills, though in another series the difference barely reached significance (Tew & Laurence, 1975).
SPINA BIFIDA CHILDREN'S SCORES ON THE WECHSLER INTELLIGENCE SCALE FOR CHILDREN1 BRIAN TEW IVehh National School of Medicine Summary.-An analysis of the scores of 58 cases assessed on the WISC suggested there was a differential intellectual prognosis according to type of lesion, the presence of hydrocephalus, degree of physical disability and sex, with girls having the poorer outcome. Spina bifida refers to three types of spinal lesion. These include ( 1 ) Meningocele, representing 5% of all cases; such children generally have a good physical prognosis. ( 2 ) Encephalocele also accounts for 5 % of all cases; these may have sensory defects, as well as spasticity, notably where brain tissue has been removed in repairing the lesion. The remainder are of ( 3 ) Myelomeningocele, the most serious manifestation of spina bifida, having a high mortality rare. More than 80% of children with this lesion also have hydrocephalus, which generally requires further neurosurgery. Between 1956 and 1962, 425 cases of spina bifida were ascertained in a defined area of South Wales. As few children had early surgery, this sample represented, as near as was possible, the narural history of the condition. In 1971, 59 children survived, with a mean age of 11.6 yr.; 32 were myelomeningoceles, 17 meningoceles, and 9 were encephaloceles. There were 34 boys and 24 girls; one child was untraced. On the Wechsler Intelligence Scale for Children this sample earned a mean Verbal 1Q of 89.1 (SD, 21.6), a Performance Scale I Q of 82.3 (SD, 22.6), and a Full Scale IQ of 84.5 (SD, 22.9). According to the qpe of lesion, for the meningoceles mean IQs were 95.0 on the Verbal Scale (SD, 15.8), 93.3 on the Performance Scale ( S D , 12.6). and 93.8 ( S D , 13.4) on the Full Scale. N o case scored under 70. Myelomeningoceles were not significantly lower. Their Verbal IQ was 94.1 ( S D , 20.5), Performance I Q 84.7 ( S D , 19.0), and Full Scale I Q 88.8 ( S D , 18.2). IQs were 70 for 16% but 22% had IQs h 100. Encephaloceles had lower IQs ( P < .001) than children with other kinds of lesion who earned a mean Verbal Scale I Q of 60.9 (SD, 21.0), a Performance Scale IQ of 52.3 ( S D , 22.4), and a Full Scale IQ of 51.9 ( S D , 22.7). Girls had lower IQs ( P < .001) than boys. The mean Verbal Scale IQ of the girls was 77.2 (SD, 20.4), the Performance I Q 70.1 ( S D , 21.4) and the Full Scale 71.3 (SD, 21.9), while the mean Verbal Scale I Q of the boys was 96.9 ( S D , 18.9), the Performance IQ 90.3 ( S D , 19.9) and the Full Scale 93.2 ( S D , 19.3). N o meningoceles had hydrocephalus and a few cases of encephalocele and myelomeningocele also escaped this complication. They had a mean Full Scale I Q of 93.3. Among the remainder, hydrocephalus was divided into three grades: mild hydrocephalus ( 1 2 cases) corresponded to a cerebral mantle thickness of t 4 cm. Their Full Scale IQ was 87.7. Moderate hydrocephalus ( 1 0 cases) had a mantle thidrness between 2 and 4 cm. Their Full Scale IQ was 77.7, and the severe hydrocephalics ( 8 cases) had a mantle thickness 2 cm. Their Full Scale IQ was 57.6. In the cases with known hydrocephalus, the mean Performance I Q was not significantly lower than verbal skills, though in another series the difference barely reached significance (Tew & Laurence, 1975).
