The relationship of neuropsychological functioning to adaptation outcome in adolescents with spina bifida

Abstract

Adolescents with spina bifida (SB) vary in their ability to adapt to the disease, and it is likely that numerous risk and protective factors affect adaptation outcomes. The primary aim was to test neuropsychological impairment, exemplified herein by executive dysfunction, as a risk factor in the Ecological Model of Adaptation for Adolescents with SB. Specific hypotheses were that: (1) executive functioning predicts the adaptation outcome of functional independence in adolescents with SB; (2) executive functioning mediates the impact of neurological severity on functional independence; and (3) family and adolescent protective factors are related to functional independence and moderate the relationship between executive functioning and functional independence. Forty-three adolescents aged 12-21 years completed neuropsychological measures and an interview that assessed risk, adolescent and family protective factors, and functional independence. Age, level of lesion, executive functioning, and the protective factor adolescent activities were significantly correlated with the functional independence outcome. In hierarchical regression analysis, the model accounted for 61% of the variance in functional independence outcomes. Executive functioning mediated the impact of neurological severity on functional independence. (JINS, 2008, 14, 793-804.)

Transition Planning for Youth With Sickle Cell Disease: Embedding Neuropsychological Assessment Into Comprehensive Care

“…Transitioning into adult life may be more problematic for these youth, perhaps because their problems with executive function compromise social problem-solving skills. 2,[7][8][9] OBSTACLES TO CARE UNDER THE TRADITIONAL MODEL Before 2007, under the traditional model, our hematology staff typically recommended a neuropsychological evaluation if families complained of learning or behavior problems. Provid-ers faxed referrals to the neuropsychology service, where testing would be scheduled on some future date, in a different building, by a neuropsychologist whom most patients had never met and whose role and rationale they rarely understood.…”

Problematic psychosocial adaptation and executive dysfunction in women and men with myelomeningocele

“…Poor adaptation during childhood and adolescence places individuals at risk for continued difficulties in adulthood, such as underemployment, unemployment, limited independence, reduced self-esteem and dependence on federal and state support programs [6]. Many of these adults are unable to live independently, and relatively few work in professional occupations [26][27][28].…”

“…Executive functions are high-level cognitive functions that activate, organize, integrate and manage other functions [5,6]. Both frontal lobe damage and disruption of white matter circuits between the prefrontal cortex and other areas of the brain can result in executive dysfunction in MMC.…”

“…Both frontal lobe damage and disruption of white matter circuits between the prefrontal cortex and other areas of the brain can result in executive dysfunction in MMC. Many patients with MMC have been observed to exhibit executive deficits such as difficulties with distractibility, organizing material, initiation and staying on task, working memory, set shifting, self-monitoring and emotional control [1,6,7]. Planning, goal-directed behaviour and problem solving are also impaired [8].…”

Profiles of Neuropsychological Functioning in Children and Adolescents with Spina Bifida: Associations with Biopsychosocial Predictors and Functional Outcomes

“…These factors were hypothesized to Neuropsychological profiles of children with SBM 805 predict group membership, such that clusters 2 and 4 would have more biological risk factors than clusters 1 and 3; and clusters 1 and 2 would have more advantageous environmental factors than clusters 3 and 4 (hypothesis 2). For the third hypothesis, it was expected that group membership would predict differences in the following areas of daily functioning: independence (Barnes, Dennis, & Hetherington, 2004;Heffelfinger et al, 2008;Tuminello, Holmbeck, & Olsen, 2012), academic success Swartwout et al, 2010), parental expectations for the future (Creed, Conlon, & Zimmer-Gembeck, 2007), and quality of life (Barf, Post, Verhoef, Prevo, & Goosken, 2010;Hetherington et al, 2006). It was expected that participants' daily functioning would depend on cluster membership, in the following order from highest to lowest level of functioning: cluster 1 "generally higher functioning with clear strengths"; cluster 3 "generally higher functioning without clear strengths"; cluster 2 "generally lower functioning with clear strengths"; and cluster 4 "generally lower functioning without clear strengths.…”