Executive functions in adolescents with spina bifida: Relations with autonomy development and parental intrusiveness

Abstract

The current study was part of a larger longitudinal investigation and examined the relation of parent-report and performance measures of executive functioning (EF) with measures of behavioral and emotional autonomy and parental intrusiveness in adolescents with and without spina bifida (SB; n = 65 in a comparison sample and 61 in an SB sample; M age = 14.55, SD = 0.63). For both groups, higher levels of parent-reported EF problems predicted higher levels of observed child dependency and lower levels of teacher-reported intrinsic motivation. Higher scores on performance EF measures predicted lower levels of observed child dependency and observed maternal intrusiveness for both groups. In adolescents with SB only, higher performance EF scores predicted higher intrinsic motivation and emotional autonomy from both mother and father and predicted lower levels of observed paternal intrusiveness. While causal conclusions cannot be drawn, EFs appear to be closely related to autonomy development and parental intrusiveness, particularly for adolescents with SB. These results suggest that the inclusion of EF training in interventions targeting adolescents with SB may be beneficial for autonomy development.

Keywords:

• Spina bifida
• Executive function
• Autonomy
• Parental intrusiveness
• Adolescence

Acknowledgments

Completion of this manuscript was supported in part by research grants from the March of Dimes Birth Defects Foundation (12-FY01-0098) and the National Institute of Child Health and Human Development (RO1 HD048629). The authors wish to thank Ann Walsh Johnson, Joy Ito, Pat McGovern, Pat Braun, Caroline Anderson, David McLone, John Lubicky, the Spina Bifida Association of Illinois, the staff of the spina bifida clinics at Children's Memorial Hospital, Shriners Hospitals for Children, Chicago, and Loyola University of Chicago Medical Center. We also thank numerous undergraduate and graduate research assistants for help with data collection and data entry. Most importantly, we gratefully acknowledge the contributions to this study by the parents, children, teachers, and health professionals who participated over many years.