Limitations
There are several limitations to this study. The high rate of
cancellations and no-shows possibly resulted in a non-representative
sample, particularly given socioeconomic barriers to attendance. The
clinical nature of our program also created minor variance amongst test
setting and screening measures. The lack of a control group for our
sample precludes comparison to other children affected by chronic
illness and/or socio-economic disadvantage. Also, the cross-sectional
nature of this study limits the extent to which we can make causal
inferences or definitive conclusions about trajectories, including the
poorer performance seen in older age groups. In addition, because this
screening was designed for brevity, additional information (e.g.,
in-depth measures of executive functioning, verbal learning, and
visual-motor integration, and/or teacher report) related to was not
obtained.