Medical responsibility growth in youth with spina bifida: Neuropsychological and parenting predictors.

2021 ◽  
Vol 40 (10) ◽  
pp. 692-701
Author(s):  
Alexa R. Stern ◽  
Adrien M. Winning ◽  
Joseph R. Rausch ◽  
Grayson N. Holmbeck
Keyword(s):  
Spina Bifida ◽  
Medical Responsibility

scholarly journals Predictors of Distinct Trajectories of Medical Responsibility in Youth with Spina Bifida

2020 ◽  
Vol 45 (10) ◽  
pp. 1153-1165
Author(s):  
Mariam Kayle ◽  
David I Chu ◽  
Alexa Stern ◽  
Wei Pan ◽  
Grayson N Holmbeck
Keyword(s):  
Spina Bifida ◽  
Group Membership ◽  
Family Stress ◽  
Developmental Trajectories ◽  
Developmental Trajectory ◽  
Late Childhood ◽  
Childhood And Adolescence ◽  
Family Interactions ◽  
Medical Responsibility ◽  
And Gender

Abstract Objective To determine if there are distinct developmental trajectories of medical responsibility in youth with spina bifida (SB) across ages 8–17 years and to identify condition-related, parental, and family systems predictors of membership in these trajectory groups. Methods Participants were 140 youth with SB and their parents who participated in four waves of a longitudinal study across 6 years (ages 8–15 years at Time 1). Multi-method (questionnaires and observed family interactions) and multi-respondent assessments were conducted during home visits. Results Findings revealed that there were two distinct developmental trajectories that characterized this sample, with one being labeled “high increasing” (two thirds of the sample) and one labeled “low increasing” (one third of the sample). Most predictor variables were significantly associated with trajectory group membership, with the exception of ethnicity, SES, and measures of conflict. When all significant univariate predictors were included in the same model, only intelligence quotient (IQ), family stress, and gender were retained as significant. Conclusions Most youth exhibited relatively rapid increases in responsibility over the course of late childhood and adolescence, but there was a smaller portion of the sample that did not exhibit this type of developmental trajectory. The magnitude of the IQ effect on group differentiation appeared to attenuate the effects of most other predictors. It will be important for clinicians working with youth with SB to recognize that the transfer of medical responsibility from parent to child cannot be expected to unfold in the same manner for all families of youth with SB.

scholarly journals Pathways by which Maternal Factors are Associated With Youth Spina Bifida-Related Responsibility

2020 ◽  
Vol 45 (6) ◽  
pp. 610-621
Author(s):  
Colleen F Bechtel Driscoll ◽  
Diana M Ohanian ◽  
Monique M Ridosh ◽  
Alexa Stern ◽  
Elicia C Wartman ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Study Data ◽  
Maternal Factors ◽  
Youth Outcomes ◽  
Mediation Analyses ◽  
Medical Responsibility ◽  
Observational Measure ◽  
Adjustment Factors ◽  
Lesion Level ◽  
The Relationship

Abstract Objective Achieving condition-related autonomy is an important developmental milestone for youth with spina bifida (SB). However, the transfer of condition-related responsibility to these youth can be delayed due to parent factors. This study aimed to investigate two potential pathways by which maternal factors may be associated with condition-related responsibility among youth with SB: (a) Maternal adjustment → perception of child vulnerability (PPCV) → youth condition-related responsibility; and (b) Maternal PPCV → overprotection → youth condition-related responsibility. Methods Participating youth with SB (N = 140; Mage=11.4 years, range = 8–15 years) were recruited as part of a longitudinal study; data from three time points (each spaced 2 years apart) from the larger study were used. Mothers reported on personal adjustment factors, PPCV, and overprotection. An observational measure of overprotection was also included. Mothers, fathers, and youth with SB reported on youths’ degree of responsibility for condition-related tasks. Analyses included age, lesion level, IQ, and the dependent variables at the prior wave as covariates. Results Bootstrapped mediation analyses revealed that PPCV significantly mediated the relationship between maternal distress and youth responsibility for medical tasks such that higher levels of distress at Time 1 predicted higher levels of PPCV at Time 2 and lower youth medical responsibility at Time 3. Furthermore, self-reported maternal overprotection significantly mediated the relationship between maternal PPCV and youth responsibility for medical tasks. Conclusions Maternal personal distress, PPCV, and self-reported overprotection are interrelated and affect youth’s condition-related responsibility. Interventions for mothers of youth with SB that target these factors may improve both maternal and youth outcomes.

scholarly journals Social Skills and Medical Responsibility Across Development in Youth With Spina Bifida

2020 ◽  
Author(s):  
Colleen Stiles-Shields ◽  
Kezia C Shirkey ◽  
Adrien M Winning ◽  
Zoe R Smith ◽  
Elicia Wartman ◽  
...  
Keyword(s):  
Social Skills ◽  
Spina Bifida ◽  
Social Variables ◽  
Prosocial Skills ◽  
Time Points ◽  
Medical Responsibility ◽  
Lesion Level ◽  
Predictive Role ◽  
Positive Social Skills

Abstract Objective  To examine the predictive role of social skills in youth with spina bifida (SB) on growth in medical responsibility across development. Methods  As part of a larger, longitudinal study, 140 youth with SB were assessed across four time points (ages 8–22 across time points). Mixed-effects models were investigated for change with: (a) no predictors (i.e., change in medical responsibility across age; time was examined using the participant’s age, centered at 11.5 years); (b) social variables (i.e., observed social behaviors, parent- and teacher-reported social skills) as predictors; and (c) social variables as predictors with intelligence quotient, lesion level, and sex as covariates. Results  Significant growth with age was identified for medical responsibility (p < .0001). Observed, parent-reported, and teacher-reported social skills did not significantly predict this growth; however, all three predicted the intercept for medical responsibility at 11.5 years of age (ps ≤ .047). Parent-reported social skills remained a significant predictor of the intercept at 11.5 years of age when including the covariates (p = .008). Conclusions  Children with SB who exhibited more positive social skills were more likely to a have higher level of medical responsibility in late childhood, but higher levels of social skills were not associated with a more rapid increase in responsibility over time. Identifying existing social strengths and promoting the practice of prosocial skills may have additional benefits to children with SB, including their acquisition of medical responsibility.

Sign in / Sign up

Export Citation Format

Share Document