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

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

Profiles of Neuropsychological Functioning in Children and Adolescents with Spina Bifda

The current study examined neuropsychological performance among children with spina bifida (SB) to determine if there are distinct subgroups or profiles of cognitive functioning. 96 children with SB myelomeningocele (ages 8-15) completed a brief 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, family stress, and family environment. Outcomes included independence, academic success, expectations for the future, and quality of life. Ward\u27s cluster method indicated a 3-cluster solution, and was replicated with 2 other cluster methods. The following labels were applied to the clusters: Average Cognitive Ability, Impaired Motor (n=39), Average Cognitive Ability (n=32), and Extremely Low to Borderline (n=25). SES and shunt status significantly predicted group membership. Cluster membership significantly predicted independence, academic success, parent expectations for the future, and child reported physical quality of life. Cluster analyses identified 3 distinct cognitive profiles with different patterns of cognitive strengths and weaknesses. These clusters proved to distinguish the groups on future outcomes as well. Findings from this study highlight the variability in cognitive profiles among children with SB. Clinical implications and future research are discussed

Do Family Dynamics Mediate the Relationshp Between Early Pubertal Development and Depression for Girls With and Without Spina Bifida?

Girls who experience premature puberty have higher levels of depressive symptoms than their peers (Rierdan & Koff, 1991; Hayward et al., 1997). However, girls with spina bifida (SB) experience different psychosocial changes during puberty. This study proposed two longitudinal, mediated moderation models to investigate whether family variables (i.e., parent-child conflict and emotional distancing) contributed to differences in the connection between early pubertal timing and depressive symptoms for girls with and without SB. 62 families (31 SB, 31typically developing) were recruited for a larger longitudinal study. Constructs were assessed subjectively and objectively with the use of questionnaire and observational data. Findings did not support the hypothesis that the association between early pubertal timing and depressive symptoms depended on whether the girl had SB. However, findings did support group status as a moderator of the association between early pubertal timing and observed conflict and emotional distancing

Measuring the Effectiveness of Undergraduate Library Instruction

The purpose of this study, conducted in Spring 2013, was to evaluate the effectiveness of the undergraduate library instruction program instituted as part of the first-year English 105 course at the University of North Carolina at Chapel Hill. ACRL's Information Literacy Competency Standards for Higher Education were used to develop learning outcomes to measure students' self-efficacy in an anonymous online survey. Also measured were students' emotional responses to doing research for a paper and level of procrastination. Results indicate that all student respondents felt at least moderately confident on eight tasks, but for four of the tasks, at least one student reported having no confidence. However, the role of the library instruction program in effecting these results is inconclusive. The lack of a pre-instruction survey, in combination with poor survey response, makes it impossible to generalize the results. Nevertheless, the results can provide a baseline of comparison for future research.Master of Science in Library Scienc

Efficacy of Tinnitus Retraining Therapy (TRT) in Adults with Bothersome Tinnitus

Tinnitus is the perception of sound in the absence of an external stimulus. Hearing ringing, roaring, or rushing in the ears or head is a common phenomenon in adults, affecting about 25% of the global population. For most people, tinnitus can be easily ignored. However, 1-7% of adults in the United States are are living with bothersome, and potentially debilitating tinnitus that causes a disruption of daily life impacting their mood, sleep, and mental health (Bauer et al, 2017). There are many different types of treatment options for people with tinnitus. Some treatment options include the use of sound maskers, Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Progressive Tinnitus Management (PTM), and Tinnitus Retraining Therapy (TRT). Using a systematic review, we are interested in analyzing the efficacy of TRT. TRT focuses on both conscious and subconscious connections to attempt to reduce the perception of tinnitus. The treatment consists of intensive counseling and the addition of sound therapy. The aim of this systematic review is to assess patient’s perceived benefits from TRT

ADHD and Attention Problems in Children With and Without Spina Bifida

Objectives: To identify differences in the diagnosis and treatment of attention deficit/hyperactivity disorder (ADHD) between typically developing children and children with spina bifida. Method: Sixty-eight children with spina bifida and 68 demographically matched, typically developing children participated in a larger, longitudinal study. Rates of maternal, paternal, and teacher reports of attention problems, as well as rates of maternal reports of ADHD diagnosis, diagnosing provider, pharmaceutical treatment, mental health treatment, and academic accommodations were obtained at 5 time points over a period of 8 years and were compared across groups. Results: Children with spina bifida were more likely to have an ADHD diagnosis and attention problems. Attention problems and ADHD diagnoses were first reported at earlier time points for children with spina bifida than typically developing children. Among children with ADHD or attention problems, children with spina bifida were more likely to be treated with medication, but they were just as likely to use mental health services and receive resource services at school. Conclusions: Children with spina bifida were diagnosed with ADHD and identified as having attention problems more frequently and at an earlier age. This finding could be due to earlier symptom development, greater parental awareness, or more contact with providers. Among those with ADHD or attention problems, stimulant medication was more likely to be prescribed to children with spina bifida, despite research that suggests it may not be as beneficial for them. Further research on the effectiveness of ADHD pharmacological treatment for children with spina bifida is recommended

Benefit finding among parents of young children with type 1 diabetes

Benefit finding, perceived positive effects of adversity, has been associated with psychological well‐being in people with chronic illnesses and with better adherence for adolescents with type 1 diabetes (T1D). Our qualitative research with parents of young children (< 6 years old) with T1D indicated that benefit finding (BF) is a common parental coping mechanism, but no tools exist to measure BF in parents. We determined psychometric properties of the Diabetes Benefit Finding Scale for Parents (DBFS‐P), a 16‐item questionnaire adapted from the validated adolescent version. Parents of young children with T1D (n = 172) were participants in a randomized trial of an online intervention. We examined the DBFS‐P factor structure through principal component analysis (PCA); internal consistency through Cronbach’s alpha; convergent validity via bivariate correlations between the DBFS‐P and measures of parental depression, anxiety, T1D self‐efficacy, and hypoglycemia fear; and discriminant validity via bivariate correlations between the DBFS‐P and measures of parental somatization and child behavior problems. PCA revealed one factor (56.47% variance) with Cronbach’s α = 0.95. Convergent validity of the DBFS‐P was supported by significant correlations with parental depression (r = −0.35, P < 0.001), anxiety (r = −0.20, P = 0.008), T1D self‐efficacy (r = 0.36, P < 0.001), and hypoglycemia fear (r = 0.27, P < 0.001). Non‐significant correlations with parental somatization (r = −0.06, P = 0.42) and child behavior problems (r = −0.12, P = 0.14) support its discriminant validity. The DBFS‐P demonstrated good psychometric properties as a tool for assessing BF among caregivers.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/150510/1/pedi12860_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/150510/2/pedi12860.pd