Which of the following is a sign of shunt malfunction in school-aged children?

• A. Decreased school performance
• B. Headaches
• C. Normal handwriting
• D. Regular attendance

Answer: (A)

A key sign to watch for in school-aged children with a shunt issue is a noticeable drop in academic performance. When CSF flow is disrupted and intracranial pressure rises, brain function can be affected, especially areas involved in attention, memory, processing speed, and problem-solving. These cognitive changes often show up as poorer grades, missed assignments, or falling behind in school, making decreased school performance a practical and important cue for caregivers and clinicians. Headaches can occur with shunt problems, but they’re non-specific and may have many causes; normal handwriting and regular attendance suggest stable neurological status and are less likely indicators of a shunt malfunction.