The Cognitive and Academic Impact Of Sickle Cell Disease

Abstract

Sickle cell disease (SCD) affects over 30,000 students in the United States. Central nervous system complications are widespread among students with SCD and include stroke, silent cerebral infarction, and cognitive impairment. The effects of these complications may lead to academic failure, limited career options, and for some, total disability. Despite studies describing the significant academic and cognitive impact of sickle cell disease, reports describing interventions are limited. There is a lack of awareness among educators of the academic risks associated with sickle cell disease and a lack of appropriate resource allocation. The school nurse, as community health advocate, will be called upon to bridge the gap among healthcare providers, parents, students, and educators. This article provides a review of both recent and landmark studies describing the cognitive and academic impact of sickle cell disease and discusses the role of the school nurse as an advocate, liaison, and educator.

Neuropsychiatric Impairment among Patients with Sickle Cell Anemia

“…The findings in this study were not in good agreement with the reports from previous studies that had observed statistically worse cognitive performance among children with SCA [11,33]. Day et al [8] observed from a review of studies comparing cognitive function among SCA patients and control that there was a significantly poorer performance in SCA patients in up to 71% of the papers reviewed. The findings of no significant difference in global cognitive performance between our SCA and controls despite the fact that there was statistically significant difference in the age of the SCA group and control is in good agreement with previous conclusion from a review.…”

“…The findings of no significant difference in global cognitive performance between our SCA and controls despite the fact that there was statistically significant difference in the age of the SCA group and control is in good agreement with previous conclusion from a review. Moreover, it observed that the age of controls among younger people has little effect on their performance [8].…”

“…Among these complications are overt stroke or silent cerebral infarction, and impairment in cognitive function. Moreover, these are among the most devastating long-term complications of the disease [6,8]. Brain damage can be present in SCD patients without any clinical evidence of stroke [8].…”

“…Moreover, these are among the most devastating long-term complications of the disease [6,8]. Brain damage can be present in SCD patients without any clinical evidence of stroke [8]. However, silent cerebral infarction, defined as an ischemic change in brain tissue in the absence of any clinical history of stroke, is observed by magnetic resonance imaging (MRI) in approximately 17% of the patients with SCA [9,10].…”

Spirituality and Religiosity in Adolescents Living With Sickle Cell Disease

“…Less oxygen, along with increased metabolic demands, may lead to delayed growth and sexual development, which can be very concerning to adolescents with SCD (Bennett, 2011;Sarjeant & Sarjeant, 2001). In addition, teens with SCD may have concerns regarding academic failure (Day & Chismark, 2006). SCD exacerbations and hospitalizations can negatively affect school attendance and attainment of educational goals.…”