AMMERMAN SPINA BIFIDA STUDY

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Adolescents with spina bifida exhibit a variety of neurocognitive deficits that are thought to impact psychosocial adjustment. It is believed that up to 40% and 50% have neuropsychological impairments indicative of nonverbal learning disability (NLD), which in turn is strongly associated with poor social adjustment and internalizing behavior problems (e.g., depression). In general, adolescents with spina bifida display problems in behavioral, social, and personality adjustment, although there is considerable variability in this population. This study (entitled the Learning and Development Project) is examining the relationship between type and severity of neuropsychological impairment, in particular the NLD profile, and psychosocial functioning in adolescents with spina bifida. Specifically, 160 adolescents with spina bifida between the ages of 10-17 years and their families are being recruited. They are divided equally between those with and without NLD using specific criteria. Adolescents are divided equally between four age groups (10-12, 12-14, 14-16, 16-17 years) and by gender. At baseline, adolescents complete a comprehensive neuropsychological battery, which will be used to create the two groups and more fully elucidate the NLD profile. At this time, parents and adolescents also complete several measures of the child's psychosocial functioning and family adjustment. Eighteen months later, they receive a follow-up assessment measuring behavioral, social, and personality functioning. At both assessment points, the adolescent's teacher completes several measures of psychosocial functioning. A third group of 75 adolescents with NLD, but without spina bifida or hydrocephalus, is also being recruited and administered the same protocol at each time point. Finally, a fourth group of 75 adolescents without NLD or spina bifida or hydrocephalus, is being recruited to serve as controls. Primary goals of the study are to (1) contrast the four groups to identify differential patterns of psychosocial maladjustment at different points in adolescent development, (2) determine the predictive utility of the NLD profile to subsequent psychosocial functioning, and to determine if psychosocial problems increase with age in those with NLD, and (3) test whether family functioning moderates the association between neuropsychological impairment and psychosocial adjustment. Results from this study will elucidate causal relationships between neuropsychological impairment and psychosocial functioning in adolescents with spina bifida, delineate risk factors that will contribute to early identification and the design of more effective interventions, and reveal patterns of psychosocial functioning across age in adolescence.