The interrelationship between biological and social risk factors and cognitive outcome in individuals with myelomeningocele was examined. The Kaufman Brief Intelligence Test (K-BIT) was administered to 65 children and young adults, age range 4 to 29 during a recent clinic visit. Unshunted individuals had scores in the average range and individuals with uncomplicated hydrocephalus in the low-average range. Although the level of lesion was found to be most strongly associated with total K-BIT score, examination of subscores indicated that socioeconomic status was'the factor most strongly associated with Vocabulary score. The importance of both social and biological factors in predicting cognitive outcome in this population is useful in planning intervention strategies.Individuals I~orii with tii~elonicningot~elr are at an inrirased risk forrogniti~eiin~~airniciits (X1o~~stoneet al. 1984, Shafferet al. 1985. JIazur et 81. 1988. \\'ills et al. 1990 The putpose of this study \VRS to investigate the interrelationship betwen biologiral and social tisk factors aiid rogiiitive outcome in indivitluals wit ti iiiyeloinc~iiiiigorele. \\' e Iiypothesizetl that there is a specific coinl)itiation of sorial and inetliral factota that air most predictive of c,ognitiveoiitronic. MethodOne-huntlied and sis intlivitluals with m~elotneiiiiigorclr iweive spcializetl inetliral ('HIP at the ('hild Development Center ~lyelomrningorrle Clinic of Rhotle Island Hospital in Providence. Khotle Island. Sisty-five (61 ' % ) individuals. \vho were Imrn between 196i atid 1991 \vcir inclutled in this study. The mean age (?SIl) of the subjects was 13k6.8 years with a range from 4 toP9yeaixThe inetliral ircoids of all subjects iveir trviewved. Data sources included inpitient trcords from R hotle Island Hospital and outpatient clinic. t~roids from the ('hilt1 Developnient Center. Alediral data inrlutletl the pirsenre of shunted hydrocephalus. the number of sliuiit inalfuiictions and infertions \vhirh required shunt irvisions. the sensory motor level oft lie lesion antl history ofseizuirs. Psyrhosocial data iiic4uded tiiaci- S I'RI E( 'TS
CDT can achieve reasonable results in this group of challenging patients and may be seen as a useful accessory in the vascular toolkit. However, precise indications for its use need further clarification.
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