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

摘要

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.