Affiliations: Department of Psychology, University of Houston,
Houston, TX, USA | Department of Pediatrics, Baylor College of Medicine,
Houston, TX, USA | Departments of Psychology, Psychiatry, and Surgery,
University of Toronto, Toronto, ONT., Canada
Note: [] Address for correspondence: Jack M. Fletcher, University of
Houston, Department of Psychology, 2151 W. Holcombe Blvd., 222 TMC Annex,
Houston, TX 77204-5053, USA. Tel.: +1 832 842 2006; Fax: +1 713 797 0992;
E-mail: jackfletcher@uh.edu
Abstract: We review neurobehavioral outcomes and interventions for children
with spina bifida. Focusing on children with spina bifida myelomeningocele, we
contrast historical views of outcomes based on comparisons across content
domains (e.g., language versus visual perceptual skills) with a view based on
overarching processes that underlie strengths and weakness within content
domains. Thus, we suggest that children with SBM have strengths when the skill
involves the capacity to retrieve information from semantic memory and generate
material that has been associatively linked or learned (associative
processing) and general difficulties on tasks that require the construction or
integration of a response (assembled processing). We use a hypothetical
case to illustrate the differences in content domains versus general processes
and also identify interventions that may be effective in addressing some of the
cognitive and behavioral difficulties experienced variably by people with SBM.
We extend these general principles to a discussion of variability in outcomes
and use data from a large sample of children with spina bifida to illustrate
the basis for this variability.
