Most children with Neurofibromatosis Type 1 (NF1) have difficulties with learning and/or behavior; however, these problems vary significantly between individuals. While deficits may affect all areas of learning and behavior, other impairments only affect one area.
Adaptive functioning measures an individual’s ability to achieve age-appropriate maturity, judgment and reasoning, social sensibility, and personal independence. Adaptive functioning affects all areas of early childhood development and is closely linked to long-term outcomes in individuals with intellectual disability, autism spectrum disorder, and attention-deficit/hyperactivity disorder (ADHD).
In a new report published in Developmental Medicine and Child Neurology in August 2019, Dr. Stephanie Morris, Assistant Professor of Neurology, and her colleagues showed that deficits in adaptive functioning are common in children with NF1. In her study, nearly half of children with NF1 exhibited adaptive behaviors in the borderline or impaired range. Moreover, they discovered three distinct subgroups of children with NF1 – those with poor adaptive and cognitive functioning, those with normal adaptive and cognitive functioning, and those with a relative dissociation in adaptive and cognitive functioning (poor adaptive functioning and normal cognitive ability. They further demonstrated that impairments in adaptive functioning were highly correlated with deficits in executive functioning, externalizing behaviors, and attention.
These findings strongly support the use of formal neuropsychological testing, including assessment of adaptive functioning for any child with NF1 who displays difficulty at home, in school, or in personal relationships despite academic achievement.