Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-23T00:55:18.463Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  30 August 2016

Rachel M. Wasserman  and
Grayson N. Holmbeck
Rachel M. Wasserman*
Affiliation:
Baylor College of Medicine, Houston, Texas
Grayson N. Holmbeck
Affiliation:
Loyola University Chicago, Chicago, Illinois
*
Correspondence and reprint requests to: Rachel M. Wasserman, Texas Children’s Hospital, 1102 Bates Street C.0940.32, Houston, TX 77030-2399. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: The current study examined neuropsychological performance among children with spina bifida (SB) to determine biological and functional correlates of distinct “profiles” of cognitive functioning. Methods: A total of 95 children with SB myelomeningocele (ages, 8–15 years) completed a neuropsychological assessment battery. Hierarchical and non-hierarchical cluster analyses were used to identify and confirm a cluster solution. Hypothesized predictors of cluster membership included lesion level, number of shunt surgeries, history of seizures, age, ethnicity, socio-economic status, and family stress. Outcomes included independence, academic success, expectations for the future, and quality of life. Results: Ward’s cluster method indicated a three-cluster solution, and was replicated with two other cluster analytic methods. The following labels were applied to the clusters: “average to low average” (n=39), “extremely low to borderline” (n=27), and “broadly average with verbal strength” (n=29). Socio-econimc status, lesion level, and seizure history significantly predicted group membership. Cluster membership significantly predicted independence, academic success, parent expectations for the future, and child reported physical quality of life. Conclusions: Findings from this study suggest qualitatively different cognitive profiles exist among children with SB, and the relevance of neuropsychological functioning for day-to-day adaptive functioning and quality of life. Clinical implications and future research are discussed. (JINS, 2016, 22, 804–815)

Keywords

MeningomyeloceleCognitionPhenotypeQuality of lifeChildAdolescent
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 22 , Issue 8 , September 2016 , pp. 804 - 815
Copyright
Copyright © The International Neuropsychological Society 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, T.M., & Rescorla, L.A. (2001). Manual for the ASEBA school-age forms & profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.Google Scholar
Aikens, N.L., & Barbarin, O. (2008). Socioeconomic differences in reading trajectories: The contribution of family, neighborhood, and school contexts. Journal of Educational Psychology, 100, 235–251.Google Scholar
Aldenderfer, M.S., & Blashfield, R.K. (1984). Cluster analysis. Beverly Hills: Sage.Google Scholar
Argento, A.G., Warschausky, S.A., Shank, L., & Hornyak, J.E. (2011). Spina bifida myelomemingocele. In S. Goldstein & C.R. Reynolds (Eds.), Handbook of neurodevelopmental and genetic disorders in children (2nd ed., pp. 554–569). New York: Guilford Press.Google Scholar
Barf, H.A., Post, M.W.M., Verhoef, M., Prevo, A.J.H., & Gooskens, R.H.J.M. (2010). Is cognitive functioning associated with subjective quality of life in young adults with Spina bifida and hydrocephalus? Journal of Rehabilitation Medicine, 42(1), 56–59.Google Scholar
Barf, H.A., Verhoef, M., Jennekens-Schinkel, A., Post, M.W.M., Gooskens, R.H.J.M., & Prevo, A.J.H. (2003). Cognitive status of young adults with spina bifida. Developmental Medicine & Child Neurology, 45(12), 813–820.Google Scholar
Barnes, M.A., & Dennis, M. (1992). Reading in children and adolescents after early onset hydrocephalus and in their normally developing age-peers: Phonological analyses, word recognition, word comprehension, and passage comprehension skill. Journal of Pediatric Psychology, 17, 445–456.Google Scholar
Barnes, M.A., & Dennis, M. (1998). Discourse after early-onset hydrocephalus: Core deficits in children of average intelligence. Brain and Language, 61, 309–334.Google Scholar
Barnes, M.A., Dennis, M., & Hetherington, R. (2004). Reading and writing skills in young adults with spina bifida and hydrocephalus. Journal of the International Neuropsychological Society, 10, 655–663.Google Scholar
Barnes, M.A., Pengelly, S., Dennis, M., Wilkinson, M., Rogers, T., & Faulkner, H. (2002). Mathematics skills in good readers with hydrocephalus. Journal of the International Neuropsychology Society, 8, 72–82.Google Scholar
Barnes, M.A., Wilkinson, M., Khemani, E., Boudesquie, A., Dennis, M., & Fletcher, J.M. (2006). Arithmetic processing in children with spina bifida: Calculation accuracy, strategy use, and fact retrieval fluency. Journal of Learning Disabilities, 39, 174–187.Google Scholar
Borgen, F.H., & Barnett, D.C. (1987). Applying cluster analysis in counseling psychology research. Journal of Counseling Psychology, 34(4), 456–468.Google Scholar
Brewer, V.R., Fletcher, J.M., Hiscock, M., & Davidson, K.C. (2001). Attention processes in children with shunted hydrocephalus versus attention deficit/hyperactivity disorder. Neuropsychology, 15, 185–198.Google Scholar
Brown, T.M., Ris, M.D., Beebe, D., Ammerman, R.T., Oppenheimer, S.G., Yeates, K.O., & Enrile, B.G. (2008). Factors of biological risk and reserve associated with executive behaviors in children and adolescents with spina bifida myelomeningocele. Child Neuropsychology, 14, 118–134.Google Scholar
Bruininks, R.H., Woodcock, R.W., Weatherman, R.F., & Hill, B.K. (1996). Scales of independent behavior-revised: Comprehensive manual. Itasca, IL: Riverside Publishing.Google Scholar
Bourgeouis, M., Sante-Rose, C., Cinalli, G., Maixner, W., Malucci, C., Zerah, M., & Aicardi, J. (1999). Epilepsy in children with shunted hydrocephalus. Journal of Neurosurgery, 90, 274–281.Google Scholar
Carrow-Woolfolk, E. (1999). CASL: Comprehensive assessment of spoken language manual. Circle Pines, MN: American Guidance Service, Inc.Google Scholar
Clatworthy, J., Buick, D., Hankins, M., Weinman, J., & Horne, R. (2005). The use and reporting of cluster analysis in health psychology: A review. British Journal of Health Psychology, 10, 329–358.CrossRefGoogle ScholarPubMed
Creed, P.A., Conlon, E.G., & Zimmer-Gembeck, M.J. (2007). Career barriers and reading ability as correlates of career aspirations and expectations of parents and their children. Journal of Vocational Behavior, 70(2), 242–258.CrossRefGoogle Scholar
Delis, D.C., Kaplan, E., & Kramer, J.H. (2001). Delis Kaplan Executive Function System: Examiner’s manual. San Antonio, TX: The Psychological Corporation.Google Scholar
Dennis, M., & Barnes, M.A. (1993). Oral discourse skills in children and adolescents after early-onset hydrocephalus: Linguistic ambiguity, figurative language, speech acts, and script-based inferences. Journal of Pediatric Psychology, 18, 639–652.CrossRefGoogle Scholar
Dennis, M., & Barnes, M.A. (2010). The cognitive phenotype of spina bifida meningomyelocele. Developmental Disabilities Research Reviews, 16, 31–39.Google Scholar
Dennis, M., Fitz, C.R., Netley, C.T., Sugar, J., Harwood-Nash, D.C.F., Hendrick, E.B. Hoffman, H.J., Humphreys, R.P. (1981). The intelligence of hydrocephalic children. Archives of Neurology, 38(10), 607–615.CrossRefGoogle ScholarPubMed
Dennis, M., Jacennik, B., & Barnes, M. (1994). The content of narrative discourse in children and adolescents after early-onset hydrocephalus and in normally developing age peers. Brain Language, 46, 129–165.Google Scholar
Dennis, M., Landry, S.H., Barnes, M., & Fletcher, J.M. (2006). A model of neurocognitive function in spina bifida over the life span. Journal of the International Neuropsychological Society, 12, 285–296.Google Scholar
Devine, K.A., Holmbeck, G.N., Gayes, L., & Purnell, J.Q. (2012). Friendships of children and adolescents with spina bifida: Social adjustment, social performance, and social skills. Journal of Pediatric Psychology, 37(2), 220–231.Google Scholar
Fisher, L., Chesla, C.A., Skaff, M.A., Gillis, C., Kanter, R.A., Lutz, C.P., & Bartz, R.J. (2000). Disease management status: A typology of Latino and Euro-American patients with type 2 diabetes. Behavioral Medicine, 26(2), 53–66.CrossRefGoogle ScholarPubMed
Fletcher, J.M., Brookshire, B.L., Landry, S.H., Bohan, T.P., Davidson, K.C., Francis, D.J., & Morris, R.D. (1996). Attentional skills and executive Functions in children with early hydrocephalus. Developmental Neuropsychology, 12(1), 53.Google Scholar
Fletcher, J.M., Copeland, K., Frederick, J.A., Blaser, S.E., Kramer, L.A., Northrup, H., & Dennis, M. (2005). Spinal lesion level in spina bifida: A source of neural and cognitive heterogeneity. Journal of Neurosurgery: Pediatrics, 102, 268–279.Google ScholarPubMed
Fletcher, J.M., & Dennis, M. (2009). Spina bifida and hydrocephalus. In K.O. Yeates (Ed.), Pediatric neuropsychology: Research, theory, and practice. (pp. 3–25). New York: Guilford Press.Google Scholar
Fletcher, J.M., Francis, D.J., Thompson, N.M., Davidson, K.C., & Miner, M.E. (1992). Verbal and nonverbal skill discrepancies in hydrocephalic children. Journal of Clinical and Experimental Neuropsychology, 14, 593–609.Google Scholar
Fletcher, J.M., Ostermaier, K.K., Cirino, P.T., & Dennis, M. (2008). Neurobehavioral outcomes in spian bifida: Processes versus outcomes. Journal of Pediatric Rehabilitation Medicine, 1, 311–324.Google Scholar
Fulton, J.B., & Yeates, K.O. (2010). Spina bifida myelomeningocele. In J.E. Morgan, I.S. Baron, & J.H. Ricker (Eds.), Clinical neuropsychology. (pp. 78–86). New York: Oxford University Press.Google Scholar
Hampton, L.E., Fletcher, J.M., Cirino, P.T., Blase, S., Drake, J., Dennis, M.N., & Kramer, L.A. (2011). Hydrocephalus status in spina bifida: An evaluation of variations in neuropsychological outcomes - Clinical article. Journal of Neurosurgery: Pediatrics, 8(3), 289–298.Google Scholar
Henry, D.B., Tolan, P.H., & Gorman-Smith, D. (2005). Cluster analysis in family psychology research. Journal of Family Psychology, 19, 121–132.Google Scholar
Hetherington, R., Dennis, M., Barnes, M., Drake, J., & Gentili, F. (2006). Functional outcome in young adults with spina bifida and hydrocephalus. Child’s Nervous System, 22(2), 117–124.Google Scholar
Heffelfinger, A.K., Koop, J.I., Fastenau, P.S., Brei, T.J., Conant, L., Katzenstein, J., & Sawin, K.J. (2008). The relationship of neuropsychological functioning to adaptation outcome in adolescents with spina bifida. Journal of the International Neuropsychological Society, 14(5), 793–804.Google Scholar
Hollingshead, A.A. (1975). Four-factor index of social status. Unpublished manuscript. New Haven, CT: Yale University.Google Scholar
Holmbeck, G.N., Belvedere, M.C., Christensen, M., Czerwinski, A.M., Hommeyer, J.S., Johnson, S.Z., & Kung, E. (1998). Assessment of adherence with multiple informants in pre-adolescents with spina bifida: Initial development of a multidimensional, multitask parent-report questionnaire. Journal of Personality Assessment, 70, 427–440.CrossRefGoogle ScholarPubMed
Hommet, C., Billard, C., Gillet, P., Barthez, M.A., Lourmiere, J.M., Santini, J.J., & Autret, A. (1999). Neuropsychologic and adaptive functioning in adolescents and young adults shunted for congenital hydrocephalus. Journal of Child Neurology, 14(3), 144–150.Google Scholar
Iddon, J.L., Morgan, D.J., Loveday, C., Sahakian, B.J., & Pickard, J.D. (2004). Neuropsychological profile of young adults with spina bifida with or without hydrocephalus. Journal of Neurology, Neurosurgery, and Psychiatry, 75(8), 1112–1118.Google Scholar
Jenkinson, M.D., Campbell, S., Hayhurst, C., Clark, S., Kandasamy, J., Lee, M.K., Flynn, A., … Mallucci, C.L. (2011). Cognitive and functional outcome in spina bifida-Chiari II malformation. Child’s Nervous System, 27(6), 967–974.Google Scholar
Lindquist, B., Uvebrant, P., Rehn, E., & Carlsson, G. (2009). Cognitive functions in children with myelomeningocele without hydrocephalus. Child’s Nervous System, 25(8), 969–975.Google Scholar
Manly, T., Robertson, I.H., Anderson, V., & Nimmo-Smith, I. (1999). TEA-Ch: The test of everyday attention for children. London: Harcourt Assessment.Google Scholar
McLoyd, V.C. (1998). Socioeconomic disadvantage and child development. The American Psychologist, 53, 185–204.Google Scholar
Moodi, E., & Sarstedt, M. (2011). A concise guide to market research. Verlag Berlin, Heidelberg: Springer.Google Scholar
Naglieri, J.A., & Das, J.P. (1997). Cognitive assessment system administration and scoring manual. Itasca, IL: Riverside Publishing Google Scholar
Nowicki, S. (2003). Manual for the receptive tests of the diagnostic analysis of nonverbal accuracy 2: DANVA2. Unpublished manual.Google Scholar
Quittner, A.L., Glueckauf, R.L., & Jackson, D.N. (1990). Chronic parenting stress: Moderating versus mediating effects of social support. Journal of Personality and Social Psychology, 59, 1266–1278.CrossRefGoogle Scholar
Rose, B., & Holmbeck, G.N. (2007). Attention and executive functions in adolescents with spina bifida. Journal of Pediatric Psychology, 32, 983–994.CrossRefGoogle ScholarPubMed
Sattler, J.M. (2008). Assessment of children: Cognitive foundations. (Vol. 1 5th ed.) San Diego: Jerome M. Sattler Publisher, Inc.Google Scholar
Scott, M.A., Fletcher, J.M., Brookshire, B.L., Davidson, K.C., Landry, S.H., Bohan, T.C., & Francis, D.J. (1998). Memory functions in children with early hydrocephalus. Neuropsychology, 12(4), 578–589.CrossRefGoogle ScholarPubMed
Snow, J.H. (1999). Executive processes for children with spina bifida. Children’s Health Care, 28(3), 241–253.Google Scholar
Snow, J.H., Prince, M., Souheaver, G., Ashcraft, E., Stefans, V., & Edmonds, J. (1994). Neuropsychological patterns of adolescents and young adults with spina bifida. Archives of Clinical Neuropsychology, 9(3), 277–287.Google Scholar
Soare, P.L., & Raimondi, A.J. (1977). Intellectual and perceptual motor characteristics of treated myelomeningocele in children. American Journal of Diseases of Children, 131, 199–204.Google Scholar
Steele, R.G., & Aylward, B.S. (2007). The use of cluster analytic techniques in developmental and behavioral pediatric research. Journal of Developmental and Behavioral Pediatrics, 28, 327–329.Google Scholar
Steele, R.G., Dreyer, M.L., & Phipps, S. (2004). Patterns of maternal distress among children with cancer and their association with child emotional and somatic distress. Journal of Pediatric Psychology, 29, 507–518.Google Scholar
Sternberg, R.J. (2004). Culture and intelligence. American Psychologist, 59, 325–338.Google Scholar
Swartwout, M.D., Garnaat, S.L., Myszka, K.A., Fletcher, J.M., & Dennis, M. (2010). Associations of ethnicity and SES with IQ and achievement in spina bifida meningomyelocele. Journal of Pediatric Psychology, 35(9), 927–936.Google Scholar
Tabachnick, B.G., & Fidell, L.S. (2013). Using multivariate statistics (6th ed). Boston: Allyn and Bacon.Google Scholar
Tuminello, E.R., Holmbeck, G.N., & Olson, R. (2012). Executive functions in adolescents with spina bifida: Relations with autonomy development and parental intrusiveness. Child Neuropsychology, 18, 105–124.Google Scholar
Vinck, A., Maassen, B., Mullaart, R., & Rotteveel, J. (2006). Arnold-Chiari-II malformation and cognitive functioning in spina bifida. Journal of Neurology, Neurosurgery, and Psychiatry, 77(9), 1083–1086.Google Scholar
Wechsler, D. (1999). WASI: Wechsler Abbreviated Scale of Intelligence Manual. San Antonio, TX: Harcourt Assessment, Inc.Google Scholar
Wilkinson, G.S. (1993). WRAT3: Wide Range Achievement Test Administration Manual. Wilmington, DE: Wide Range, Inc.Google Scholar
Wills, K.W. (1993). Neuropsychological functioning in children with spina bifida and/or hydrocephalus. Journal of Clinical Child Psychology, 22, 247–265.Google Scholar
Varni, J.W., Seid, M., & Kurtin, P.S. (2001). PedsQL (TM ) 4.0: Reliability and validity of the Pediatric Quality of Life Inventory (TM ) Version 4.0 Generic Core Scales in healthy and patient populations. Medical Care, 39, 800–812.Google Scholar
Yeates, K.O., Enrile, B., Loss, N., Blumenstein, E., & Delis, D.C. (1995). Verbal learning and memory in children with myelomeningocele. Journal of Pediatric Psychology, 20, 801–812.Google Scholar
Yeates, K.O., Loss, N., Colvin, A.N., & Enrille, B.G. (2003). Do children with myelomeningocele and hydrocephalus display nonverbal learning disabilities? An empirical approach to classification. Journal of the International Neuropsychological Society, 9, 653–662.Google Scholar