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Lead is a neurotoxic substance that has been shown in numerous research studies to affect brain function and development. Children who have been exposed to elevated levels of lead (>5 ug/dl) are at increased risk for cognitive and behavioral problems during development (CDC, 2012).

Factors which contribute to the risk of lead poisoning:

  • Intensity of exposure (highest lead level)
  • Chronicity or duration of exposure
  • Age of the child during exposure
  • Nutritional and biological status of the child
  • Degree of environmental/ developmental stimulation

Exposure to lead can result in a variety of effects upon neuropsychological functioning including deficits in general intellectual functioning, ability to sustain attention on tasks, organization of thinking and behavior, speech articulation, language comprehension and production, learning and memory efficiency, fine motor skills, high activity level, reduced problem solving flexibility and poor behavioral self-control.

Given the risk of dysfunction, the neuropsychological evaluation assesses the child's cognitive and behavioral functioning with respect to the neurotoxic effects of lead. The kinds of neuropsychological problems resulting from lead poisoning can vary with the nature of the exposure history (intensity, chronicity, age at exposure, etc.) combined with the other contributing risk factors (nutrition, environmental stimulation).

The outcome of these neuropsychological deficits for the child is often quite debilitating and include poor academic learning and performance as well as problems with the development of appropriate social relationships. It is important to understand the child's neuropsychological strengths and deficits in order to reduce the risks of lead poisoning by planning for appropriate developmental, family, educational and behavioral treatment interventions.

Checklist of Possible Neuropsychological Problems Associated with Lead

  • Delayed language or motor milestones (infant, toddler)
  • Poor speech articulation
  • Poor language understanding or usage
  • Problems maintaining attention in school or home
  • High activity level (hyperactivity)
  • Problems with learning and remembering new information
  • Rigid, inflexible problem-solving abilities
  • Delayed general intellectual abilities
  • Learning problems in school (reading, language, math, writing)
  • Problems controlling behavior (e.g., aggressive, impulsive)
  • Problems with fine or gross motor coordination

Real-World Outcomes of Lead Poisoning in Children

Poor Academic Learning and Performance

  • Learning disabilities
  • Problems paying attention
  • Disorganized approach to learning
  • Poor work completion
  • Increased risk to drop out

Poor Social Relationships

  • Communication deficits
  • Impulsive, hyperactive behavior
  • Problems sharing and taking turns
  • Increased aggression
  • Increased need for adult supervision

What Can Be Done?

Prevention

  • Lead-safe housing
  • Education of public, medical and educational communities

Intervention

  • Universal early identification
  • Lead-safe housing
  • Aggressive early medical treatment
  • Aggressive early behavioral treatment
  • Rehabilitation and special education services
  • Adequate nutrition

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