Abstract

Objective: To examine the influence of subtests that require fine motor responses on measures of intellectual ability, and compare three approaches to minimizing motor demands while assessing cognitive abilities in adolescents with cerebral palsy (CP) to the traditional method of the Wechsler Intelligence Scale for Children – Fifth edition (WISC-V). Method: Seventy adolescents with CP (M = 14 years 6 months, SD = 10 months) who were able to provide either a verbal or point response were assessed using the WISC-V administered via Q-interactive. The pencil-to-paper version of Coding was also administered. Performance on Block Design and pencil-to-paper Coding was compared to Visual Puzzles and Coding on Q-interactive, respectively. Full Scale IQ (FSIQ) scores derived according to the Traditional method of the WISC-V were compared to alternative estimates of FSIQ derived according to the Q-interactive, Nonmotor, and Motor-free methods, which minimized motor demands. Results: An additional 7–12% of participants were able to respond to Visual puzzles and Coding on Q-interactive compared to Block Design and pencil-to-paper Coding, respectively, and performance was marginally but significantly better. For 54 adolescents (Gross Motor Function Classification System (GMFCS) Level I-III) who were able to obtain FSIQ scores, the Traditional method underestimated FSIQ by 3–6 points compared to the alternative methods and the difference was most pronounced for those with more severe CP as measured by the GMFCS. Conclusion: Adolescents with CP are at an inherent disadvantage when cognitive ability is assessed using the Traditional method of the WISC-V. Findings suggest clinicians should employ the Nonmotor or Motor-free methods when assessing IQ in adolescents with CP.

摘要

目的：检查需要精细运动反应的子测试对智力测量的影响，并比较三种在评估脑瘫 (CP) 青少年认知能力时最小化运动需求的方法与传统的韦氏儿童智力量表方法– 第五版 (WISC-V)。方法： 70 名 CP 青少年（M  = 14 岁 6 个月，SD = 10 个月）能够提供口头或点反应的人使用通过 Q-interactive 管理的 WISC-V 进行评估。还管理了铅笔纸版本的编码。将块设计和纸笔编码的性能分别与 Visual Puzzles 和 Q-interactive 上的编码进行了比较。将根据 WISC-V 的传统方法得出的全量程 IQ (FSIQ) 分数与根据 Q 交互、非电机和无电机方法得出的 FSIQ 替代估计值进行比较，后者最大限度地减少了电机需求。结果：与 Block Design 和 pencil-to-paper Coding 相比，另外 7–12% 的参与者能够分别对 Q-interactive 上的视觉谜题和 Coding 做出响应，并且性能略有提高但明显更好。对于能够获得 FSIQ 分数的 54 名青少年（粗大运动功能分类系统 (GMFCS) I-III 级），与替代方法相比，传统方法将 FSIQ 低估了 3-6 分，并且对于得分更高的青少年，差异最为明显GMFCS 测量的严重 CP。结论：当使用 WISC-V 的传统方法评估认知能力时，患有 CP 的青少年处于先天劣势。研究结果表明，临床医生在评估 CP 青少年的智商时应采用非运动或无运动方法。