Assessing children's memory and learning ability following hospital admission with septicaemia and meningitis.

Research archive

• Imperial College, London, UK
• Researchers: Dr Lorraine Als, Dr Simon Nadel, Prof Elena Garralda
• Project Number: 0608.0
• Category: Treatment
• Duration: Jan 2007 - 2011
• Start Date: 01 January 2007
• Type: Lay summary
• View scientific version

This research had several aims:

• to measure memory, attention, and IQ after-effects of septic illness and meningitis in children who had been treated in a paediatric intensive care unit (PICU)
• to explore associations with academic performance and emotions and behaviour
• to understand what aspects of the acute illness may be responsible for these effects
• to explore persistence of these effects approximately one year following discharge from PICU.

The results showed that difficulties in memory, attention, IQ function, and school performance were statistically significantly increased in critically ill children when compared with healthy comparison children, and in some areas of function these problems were specially noted following meningo-encephalitis and sepsis over other critical illnesses. Moreover, statistically significantly more children with meningo-encephalitis and sepsis were at high risk for hyperactivity or post traumatic stress problems. Problems with lack of energy and sleep were however seen across all three illness groups.

More specific links were shown between both reduced spatial working memory and sustained attention and a poor ability to focus (as rated by teachers), and between worse spatial working memory and post traumatic stress symptoms.

One year follow-up of critically ill children showed that for many, the IQ and psychiatric/well-being problems present during the early months of recovery persisted over time, with some psychiatric problems getting significantly worse. It is therefore vital for parents, clinicians and teachers to become aware of these deficits so that they are in a position to help children deal with their difficulties.

Since a high stress response is part of critical illness, Prof Garralda and her team also conducted a study which aimed to explore whether children admitted to PICU had subsequent abnormalities in the regulation of the physiological stress response – as measured by changes in the levels of hormones in saliva – and whether these levels were linked to acute illness or the after effects seen.

The only significant results seen in this part of the study were between hormone levels and post traumatic stress symptoms, as well as problems with sustained attention and sleep. This suggests that the regulation of biological stress responses is altered following PICU admission and may have a role in the development of emotional and attention problems. However these tests would need to be repeated.

You can find a Q&A session about learning and behavioural problems with Dr Als and Professor Garralda here.

There is also a patient summary of the research written by Dr Als for those who took part.