Cognitive abilities in 4–12-year-old children using the number cancellation test: A cross-sectional normative study

ABSTRACT Background: Safe discharge after nitrous oxide–oxygen conscious sedation in children requires ensuring full psychomotor and cognitive recovery. The number cancellation test (NCT) can serve as an objective tool to assess these functions. However, normative data for Indian children are lacking. Aim: The aim of the study was to evaluate the cognitive abilities of 4–12-year-old children using the NCT and establish age-wise normative data under normal (nonsedated) conditions. Materials and Methods: A cross-sectional study was conducted among 246 healthy children aged 4–12 years, divided into three groups: Group I (4–6 years), Group II (7–9 years), and Group III (10–12 years). Each child completed the NCT three times, and the time taken, scores, errors, and pattern (vertical, horizontal, or random) were recorded. Data were analyzed using the Kruskal–Wallis and Chi-square tests ( P < 0.05). Results: Children in Group III completed the test in the least time (231.9 s, ≈4 min) and achieved higher average scores (119.3) compared to Group I (604.3 s, ≈10 min; 109 points). The differences in time, score, and pattern were statistically significant among age groups ( P < 0.001). Conclusion: Cognitive efficiency improves with age, as older children complete the NCT faster and with greater accuracy. These normative data may serve as baseline references for evaluating recovery following nitrous oxide conscious sedation.