Improved behavior after adenotonsillectomy in children with higher and lower IQ

• Published in: International journal of pediatric otorhinolaryngology Vol. 80; pp. 21 - 25
• Main Authors: Chung, Seockhoon, Hodges, Elise K, Ruzicka, Deborah L, Hoban, Timothy F, Garetz, Susan L, Guire, Kenneth E, Felt, Barbara T, Dillon, James E, Chervin, Ronald D, Giordani, Bruno
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01-01-2016
• Subjects: Adenoidectomy - psychology; Attention Deficit Disorder with Hyperactivity - etiology; Child; Child Behavior; Child, Preschool; Female; Humans; Intelligence; Intelligence Tests; Male; Neurobehavioral function; Otolaryngology; Pediatrics; Sleep apnea syndrome; Sleep Apnea Syndromes - psychology; Sleep Apnea Syndromes - surgery; Tonsillectomy; Tonsillectomy - psychology; Neurobehavioral function; Sleep apnea syndrome; Intelligence; Tonsillectomy; NCT00233194; www.clinicaltrials.gov
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2015.11.005

Abstract Objectives To examine whether high intellectual ability, in comparison to average or lower performance, reflects the consequences of sleep-disordered breathing and limits behavioral benefit observed 6 months after adenotonsillectomy. Methods Children aged 3–12 years ( n = 147) recruited from otolaryngology practices at two hospitals and assessed with Conners’ Parent Rating Scales and an age range-appropriate intellectual measure, the Stanford–Binet Intelligence Scale at baseline and 6 months after clinically-indicated adenotonsillectomy. Subjects were classified as having high (IQ ≥ 110), average (90 ≤ IQ < 110), or low (IQ < 90) cognitive ability. Results After adenotonsillectomy, improvements in Conners’ internalizing, externalizing, hyperactivity, and cognitive domains were observed across IQ groups (main effects for time, all p < 0.01 or better), with no evidence for differential improvements among the groups (no significant time by IQ group interactions). The magnitude of behavioral improvement among children with high IQ resembled that observed among the other two groups. Changes in the Conners’ domains were not significantly correlated with baseline IQ, age, socioeconomic status, body mass index z -score, or respiratory disturbance index. Conclusion Behavioral function can improve after adenotonsillectomy even among children with relatively high intellectual ability at baseline. Diagnosis and treatment with expectation of neurobehavioral benefit should be considered among high-performing children as readily as it is more traditionally among their lower-performing peers.