Psychomotor adaptation in children with severe chronic asthma.

Acute effects of steroid medications or hypoxic-induced brain damage have been hypothesized to cause neuropsychologic impairment in children with severe asthma. The present investigation included neuromotor, cognitive, psychosocial, and medical evaluations of 67 hospitalized asthmatic children from 9 to 14 years of age, at risk for motor dysfunction. Mean scores from the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) were similar to test norm means and were not indicative of neuromotor impairment. Scores of the BOTMP correlated significantly (P less than .01) with measures of child and family psychosocial adaptation but not with measures of cognitive ability, steroid dose at admission, or severity of asthma. Thirteen children had battery composite scores more than 1 SD below age means but did not demonstrate decreased IQ or increased steroid use, respiratory failure, seizures, or abnormal neurologic signs compared with the other 55 children. These results indicate that most severely asthmatic children, including many with histories of hypoxia and high-dose steroid use, do not demonstrate psychomotor impairments indicative of brain damage. It is concluded that neuromotor development in asthmatic children is associated with psychologic characteristics that influence adaptation to illness and activity level.