Adolescent predictors of emerging adulthood milestones in youth with spina bifida.

OBJECTIVE: To examine the predictive utility of demographic (illness status and SES), individual (neurocognitive functioning and intrinsic motivation), and family-based (parental intrusiveness) factors during adolescence on the achievement of emerging adulthood milestones in youth with and without spina bifida (SB). METHODS: Questionnaire and observational data were collected from 14/15-year-old adolescents with SB, typically developing peers, mothers, and teachers. Emerging adulthood milestones (i.e., leaving home, attending college, employment, romantic relationship experience, and number of friendships) were assessed at ages 18/19 years in the full sample and subset of youth who graduated from high school. RESULTS: Typically, developing youth were more likely to achieve milestones compared to youth with SB in the full sample but not when only high school graduates were compared. Executive function, SES, intrinsic motivation, and parental intrusiveness emerged as significant predictors for particular milestones. CONCLUSIONS: Interventions targeting executive function, intrinsic motivation, and parenting behavior may facilitate achievement of emerging adulthood milestones.

A camp-based intervention targeting independence among individuals with spina bifida.

OBJECTIVE: To design and evaluate a camp-based intervention, the goal of which was to increase independence among children, adolescents, and adults with spina bifida. METHODS: An intervention targeting independence was embedded within a typical week long camp experience. The intervention consisted of the following: collaborative (i.e., parent and camper) goal identification, group sessions consisting of psycho-education and cognitive tools, and goal monitoring by camp counselors. Camper and parent report of demographic variables, goal attainment, spina bifida knowledge, and independence were gathered. Interventionist report of adherence to the treatment manual was also collected. RESULTS: Campers made significant gains in individual goals, management of spina bifida responsibilities, and independence with general spina bifida tasks, with medium effect sizes observed in goal attainment. CONCLUSIONS: Results indicated that significant progress was made on individually oriented goals from pre- to post-camp. Design issues are discussed.

Evidence-based assessment in pediatric psychology: measures of psychosocial adjustment and psychopathology.

OBJECTIVE: To provide an evidence-based review of measures of psychosocial adjustment and psychopathology, with a specific focus on their use in the field of pediatric psychology. METHODS: As part of a larger survey of pediatric psychologists from the Society of Pediatric Psychology e-mail listserv (American Psychological Association, APA, Division 54), 37 measures were selected for this psychometric review. Measures that qualified for the review fell into one of the following three categories: (a) internalizing or externalizing rating scales, (b) broad-band rating scales, and (c) self-related rating scales. RESULTS: Psychometric characteristics (i.e., three types of reliability, two types of validity) were strong for the majority of measures reviewed, with 34 of the 37 measures meeting "well-established" evidence-based assessment (EBA) criteria. Strengths and weaknesses of existing measures were noted. CONCLUSIONS: Recommendations for future work in this area of assessment are presented, including suggestions that more fine-grained EBA criteria be developed and that evidence-based "profiles" be devised for each measure.

Parent functioning in families of preadolescents with spina bifida: longitudinal implications for child adjustment.

The purpose of this study was to test a strength-of-association model regarding possible longitudinal and bidirectional associations between parent functioning and child adjustment in families of children with spina bifida (n = 68) and families of able-bodied children (n = 68). Parent functioning was assessed across 3 domains: parenting stress, individual psychosocial adjustment, and marital satisfaction. Child adjustment was indexed by teacher-reported internalizing and externalizing symptoms, self-reported depressive symptoms, and observed adaptive behavior. Findings revealed that all 3 parent functioning variables predicted child adjustment outcomes, and that such results were particularly strong for externalizing symptoms. Associations between parent functioning and child adjustment tended to be in the direction of parent to child and were similar across both groups. These findings have implications for potential interventions targeted at helping families manage the transition into early adolescence in families of children with spina bifida as well as families of healthy children.