Date of Award

January 2025

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Michael Alperovich

Second Advisor

John Persing

Abstract

In this study, we explore the long-term cognitive capabilities and behaviors of patients in late adolescence and early adulthood who underwent corrective surgery for craniosynostosis as infants. Participants were identified from the operating records of three craniofacial plastic surgeons from a single institution. Patients 16 years of age or older who had undergone surgery as infants for any type of non-syndromic craniosynostosis were contacted via phone or email and prospectively enrolled. Participants underwent standardized neurocognitive testing using the BEERY and WASI. A subset of patients additionally underwent behavioral testing using the CAARS-2, ASR, SRS-2, and BRIEF standardized tests.A total of 32 participants were included in neurocognitive testing, with a mean age of 18.9  3.4 years old. 22 participants underwent behavioral testing with a mean age of 20  3.6 years old. The mean score for the WASI FSIQ-4 was 102, with a mean PRI score of 102 and a mean VCI score of 103, which were not significantly different than the general population. However, the mean score for BEERY VMI was 95, BEERY VP was 97, and BEERY MC was 92, all of which were significantly lower than the population average. 23% of participants scored high or very high on the CAARS-2 ADHD index, and of the 44 total patients contact, 13.6% either confirmed having a diagnosis of autism or tested moderate-severe on the SRS-2 autism screener. Patients have comparable neurocognition relative to the general population, with deficits in visual and motor integration. However, there is a significantly higher prevalence of ADHD and autism-related behaviors in this cohort. These findings are useful in counseling parents with infants who have been diagnosed with craniosynostosis, as well as in directing early screening and intervention for these patients to provide the resources and therapies families need.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 05/14/2027

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