The mission of the University of Miami Sickle Cell Center is to provide state-of-the-art care to children andadults with sickle cell disease in South Florida within a psychosocially-sensitive environment, and supportedby clinical research. Children with sickle cell disease are at risk for a variety of central nervous system (CMS)complications, including overt clinical stroke, silent infarction, increased cerebral blood flow rates, andpossibly microvascular infarction not grossly detected by neuroimaging. These CMS events affectneuropsychological performance and academic achievement. Children who experience CMS injury becauseof SCO are also at higher risk for behavior and adjustment challenges, although behavior problems are alsoassociated with higher family conflict. Family conflict has been identified as a significant stressor, andassociated with more difficulty dealing with sickle cell disease symptoms, particularly pain. Abiopsychosocial model of SCO suggests that these factors may be interrelated, and implementing positivechange in one area will possibly benefit the other areas of function. The proposed project has three specificaims (1) evaluate the effect of an intervention that provides educational support for parents to improveacademic achievement in children with SCO at risk for CMS impairment. We will accomplish this aim byrecruiting a cohort of children with HbSS or HbSjff-thal SCO, evaluating their neurocognitive function,randomly assigning them to receive either low-intensity (Annual Parent Intervention {API}) or high intensity(Quarterly Parent Intervention {QPI}) parent educational support, and then repeating evaluation of academicachievement annually for three years; (2) Evaluate the effect of the intensity of the parent intervention onnon-academic factors of behavioral adjustment of the children, parenting stress, family conflict, andfrequency of pain significant enough to disrupt function and interfere with school attendance; and (3) explorethe relationship between academic achievement, behavioral adjustment, parenting stress and family conflict,and pain frequency. We will accomplish this aim by exploring the propsed relationship between thesefactors. This goal of this project is take the biopsychosocial-developmental model in a new direction-onethat will provide empirical data for a supportive psychoeducational intervention with children with sickle celldisease and their families in order to improve academic outcomes.
| Armstrong, F Daniel; Elkin, T David; Brown, R Clark et al. (2013) Developmental function in toddlers with sickle cell anemia. Pediatrics 131:e406-14 |
| Lo, Joan C; Sinaiko, Alan; Chandra, Malini et al. (2013) Prehypertension and hypertension in community-based pediatric practice. Pediatrics 131:e415-24 |
| Armstrong, F Daniel (2010) Neurocognitive function in sickle cell disease: have we been missing something? Expert Rev Hematol 3:519-21 |
