The Impact of Early-Onset Multiple Sclerosis on Cognitive and Psychosocial Indices

Objective: This study is the first systematic assessment of the impact of early-onset multiple sclerosis (MS) on youngsters’ cognitive abilities and social/emotional functioning. Background: Although adult-onset MS often is characterized by intellectual changes and challenges to psychosocial adaptation, no investigation of these MS-related problems has been done in early-onset MS. Methods: Nine subjects, aged 10 to 20, diagnosed with definite MS before age 18, were evaluated with neuropsychological and psychosocial measures. Results: Although cognitive test scores were generally within normal limits, they were characterized by considerable variability. Subjects scored significantly below the norm on the Wechsler Intelligence Scale for Children (WISC)-III Performance scale (probably indicative of incoordination, motor slowing, and/or perceptual motor difficulties) and on the Controlled Oral Word Association Test (COWAT) (reflecting the semantic verbal memory retrieval deficits reported in adults). They scored above the norm on the Wechsler Individual Achievement Test (WIAT) Oral Expression subtest, indicating heightened communication abilities. Self-Perception Profile scores generally were within normal limits; however, Social Acceptance subscale scores were above the norm, indicating a high level of perceived peer support/friendship. Conclusions: As with adults, some youngsters with MS experience an early cognitive decline that appears unrelated to degree of physical impairment. Such a decline can interfere with academic, social, and work endeavors. To identify deficits and implement appropriate interventions/accommodations, periodic neuropsychological assessments should be included in disease management from diagnosis onward. Contrary to expectations that MS would negatively impact self-concept, subjects did not view themselves as being different from peers, and showed little or no awareness of the potential impact of MS on their lives.