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Educational Placement After Pediatric Intracerebral Hemorrhage

      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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      References

        • Fullerton H.J.
        • Wu Y.W.
        • Zhao S.
        • Johnston S.C.
        Risk of stroke in children: ethnic and gender disparities.
        Neurology. 2003; 61: 189-194
        • Giroud M.
        • Lemesle M.
        • Gouyon J.B.
        • Nivelon J.L.
        • Milan C.
        • Dumas R.
        Cerebrovascular disease in children under 16 years of age in the city of Dijon, France: a study of incidence and clinical features from 1985 to 1993.
        J Clin Epidemiol. 1995; 48: 1343-1348
        • Blom I.
        • De Schryver E.L.
        • Kappelle L.J.
        • Rinkel G.J.
        • Jennekens-Schinkel A.
        • Peters A.C.
        Prognosis of haemorrhagic stroke in childhood: a long-term follow-up study.
        Dev Med Child Neurol. 2003; 45: 233-239
        • Beslow L.A.
        • Licht D.J.
        • Smith S.E.
        • et al.
        Predictors of outcome in childhood intracerebral hemorrhage: a prospective consecutive cohort study.
        Stroke. 2010; 41: 313-318
        • O'Keeffe F.
        • Ganesan V.
        • King J.
        • Murphy T.
        Quality-of-life and psychosocial outcome following childhood arterial ischaemic stroke.
        Brain Inj. 2012; 26: 1072-1083
        • Smith S.E.
        • Vargas G.
        • Cucchiara A.J.
        • Zelonis S.J.
        • Beslow L.A.
        Hemiparesis and epilepsy are associated with worse reported health status following unilateral stroke in children.
        Pediatr Neurol. 2015; 52: 428-434
        • Kitchen L.
        • Westmacott R.
        • Friefeld S.
        • et al.
        The pediatric stroke outcome measure: a validation and reliability study.
        Stroke. 2012; 43: 1602-1608
        • Beslow L.A.
        • Ichord R.N.
        • Kasner S.E.
        • et al.
        ABC/XYZ estimates intracerebral hemorrhage volume as a percent of total brain volume in children.
        Stroke. 2010; 41: 691-694
        • Kleinman J.T.
        • Hillis A.E.
        • Jordan L.C.
        ABC/2: estimating intracerebral haemorrhage volume and total brain volume, and predicting outcome in children.
        Dev Med Child Neurol. 2011; 53: 281-284
        • deVeber G.A.
        • MacGregor D.
        • Curtis R.
        • Mayank S.
        Neurologic outcome in survivors of childhood arterial ischemic stroke and sinovenous thrombosis.
        J Child Neurol. 2000; 15: 316-324
        • Friefeld S.J.
        • Westmacott R.
        • Macgregor D.
        • Deveber G.A.
        Predictors of quality of life in pediatric survivors of arterial ischemic stroke and cerebral sinovenous thrombosis.
        J Child Neurol. 2011; 26: 1186-1192
        • Neuner B.
        • von Mackensen S.
        • Krumpel A.
        • et al.
        Health-related quality of life in children and adolescents with stroke, self-reports, and parent/proxies reports: cross-sectional investigation.
        Ann Neurol. 2011; 70: 70-78
        • Friefeld S.
        • Yeboah O.
        • Jones J.E.
        • deVeber G.
        Health-related quality of life and its relationship to neurological outcome in child survivors of stroke.
        CNS Spectr. 2004; 9: 465-475
        • Gordon A.L.
        • Ganesan V.
        • Towell A.
        • Kirkham F.J.
        Functional outcome following stroke in children.
        J Child Neurol. 2002; 17: 429-434