Background and objectives: Learning difficulties are frequently reported in children with neurofibromatosis type 1 (NF1), yet little is known about the extent and predictors of their academic functions across ages. We aimed to examine the developmental patterns of academic achievement in these children from childhood to adolescence and how these patterns differ across demographic and NF1-related disease factors.
Methods: This cross-sectional study integrated data of 1512 children with NF1 (mean age, 11.2 years, SD, 3.62, range, 3-18, 46.5% female patients) from 8 institutions. Academic functioning was assessed with Woodcock-Johnson Tests of Achievement or the Wechsler Individual Achievement Test. Data were analyzed primarily using time-varying effect modeling.
Results: Participants' academic achievement was significantly lower than the normative means across ages, and the gap widened from middle childhood to midadolescence. Academic age trends varied across academic domains and demographic and disease factors. Male patients demonstrated larger deviations in math at midchildhood and in reading and writing between midchildhood and midadolescence. Children with lower parental education demonstrated larger deviations in math, reading, and writing between midchildhood and midadolescence. Children with familial NF1 demonstrated larger deviations in math at midchildhood and mid-to-late-adolescence, and in reading and writing between midchildhood and midadolescence.
Conclusions: Academic difficulties in children with NF1 emerge early and worsen with age. The findings also highlight the variability within this population across demographic and disease factors. The age-specific estimates of academic functions can serve as the first NF1-specific academic norms, providing useful insights for future research and practice.
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