Abstract
Background
This study describes educational placement of school-aged children after spontaneous
intracerebral hemorrhage and examines whether educational placement is associated
with severity of neurological deficits.
Methods
Children with spontaneous intracerebral hemorrhage presenting from 2007 to 2013 were
prospectively enrolled at three tertiary children's hospitals. The Pediatric Stroke
Outcome Measure and parental interview gathered information about neurological outcome,
school attendance, and educational placement.
Results
The cohort of 92 enrolled children included 42 school-aged children (6 to 17 years)
with intracerebral hemorrhage. Four children died; one was excluded because of preexisting
cognitive deficits. Thirty-seven children completed three-month follow-up, and 30
completed 12-month follow-up. At 12 months, 14 children (46.7%) received regular age-appropriate
programming, 12 (40%) attended school with in-class services, three (10%) were in
special education programs, and one child (3.3%) received home-based services because
of intracerebral hemorrhage–related deficits. Of 30 children with three- and 12-month
follow-up, 14 (46.7%) improved their education status, 13 (43.3%) remained at the
same education level, and three (10%) began to receive in-class services. An increasing
Pediatric Stroke Outcome Measure score predicted the need for educational modifications
at three months (odds ratio, 3.3; 95% confidence interval, 1.4 to 7.9; P = 0.007) and at 12 months (odds ratio, 2.1; 95% confidence interval, 1.1 to 3.9;
P = 0.025).
Conclusions
Most children returned to school within a year after intracerebral hemorrhage, and
many had a reduction in the intensity of educational support. However, a great need
for educational services persisted at 12 months after intracerebral hemorrhage with
fewer than half enrolled in regular age-appropriate classes. Worse deficits on the
Pediatric Stroke Outcome Measure were associated with remedial educational placement.
Keywords
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Article info
Publication history
Published online: May 09, 2016
Accepted:
May 3,
2016
Received:
February 20,
2016
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
