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Fluids and Barriers of the CNS

Open Access

Learning efficiency in children with myelomeningocele and shunted hydrocephalus

Cerebrospinal Fluid Research20041(Suppl 1):S62

Published: 23 December 2004


HydrocephalusCategory MembershipShunt InfectionAttention DisorderShunt Malfunction


Limited evidence exists regarding the efficiency with which children with MM/SH are able to learn information. This report describes initial data related to components of learning in children with MM/SH.

Materials and Methods

13 children with MM/SH and 8 age-matched non-affected controls (age range: 7–16 years) with average intelligence, and monolingual English-speaking backgrounds, participated. Exclusionary criteria for the MM/SH group were: prior history of shunt infection, history of seizure or shunt malfunction within the previous three months, prior diagnoses of attention disorders and/or clinical depression. Verbal memory tasks (learning word and word-pair lists) and nonverbal tasks (recalling positions of dots) were administered to each child. A Learning Index was computed based on performance across three learning trials of the word-pair and dot location tests. Children were also presented lists of 16 words with 8 exemplars each of two distinct semantic categories (e.g. fruits, animals), and told to make as high a score as possible by learning the words. Value of the words was designated by category membership (e.g. animals = 1; fruits = 10). Performance across three trials was used to determine a Selective Learning score.


Children in our study did worse than their age-matched controls on both learning tasks (P < 0.05). When asked what strategy was used in the selective learning tasks, 10 of the 13 MM/SH children (76%) said they tried to remember all words. In contrast, all except for one control said they tried to remember the higher point words – the more efficient strategy.


Success in school is largely dependent on the ability to selectively recall important facts and ignore less important information. Children with MM/SH in our study were unable to select and remember important information, and did not have a workable strategy. Preliminary findings are consistent with our previous clinical and research findings wherein children with MM/SH focus on many extraneous details, but are unable to remember the main gist of a story/event. Poor acquisition of new material (learning) suggests that children with MM/SH need more trials to learn than their non-affected peers and bears further exploration.

Authors’ Affiliations

Texas Scottish Rite Hospital for Children, Dallas, USA


© The Author(s) 2004

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.