Cognitive deficits occur in children with multiple sclerosis. Comprehensive treatment planning should involve recognition that they may require academic accommodations for their education.

Background Approximately one-third of those with pediatric-onset MS experience cognitive impairment. Less is known concerning their change in cognitive functioning over time. Objective Changes in cognitive function over time were measured in the largest pediatric cohort to date through the U.S. Network of Pediatric MS Centers. Methods 67 individuals with pediatric MS (n=62) or clinically isolated syndrome (CIS, n=5), ranging from 8 to 17 years of age (mean age ± SD = 14.37 ± 2.02) completed initial and followup neuropsychological testing after an average of 1.64 ± 0.63 years. The nine tests administered measure general intellect, attention and working memory, verbal memory, visuomotor integration, language, and executive functioning. Results Rate of impairment (having one-third or more scores in the impaired range) was 37% at baseline and 33% at follow-up. Tests commonly impaired were measures of visuomotor integration, speeded processing, and attention. Most tested did not decline over two years. There was no clear pattern of change on specific measures. Conclusion Findings suggest that over short timeframes, stable or even improved performances on measures of cognitive ability can occur. Rather than leading to decline, pediatric MS may instead prevent expected age-related gains.