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Attention problems and executive functions in children with spina bifida and hydrocephalus
Rachel Burmeister1, H Julia Hannay, Kim Copeland
1Department of Psychology, University of Houston, Texas, USA.
Insights
Children with spina bifida and hydrocephalus (SBH) have higher rates of Attention-Deficit/Hyperactivity Disorder (ADHD), primarily the inattentive type. Executive function differences were noted, but subtype distinctions require further research.
Area of Science:
- Neurodevelopmental disorders
- Pediatric neurology
- Cognitive psychology
Background:
- Spina bifida meningomyelocele and shunted hydrocephalus (SBH) can impact cognitive development.
- Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder.
- Understanding ADHD subtypes in SBH populations is crucial for targeted interventions.
Purpose of the Study:
- To determine the incidence of ADHD subtypes in children with SBH.
- To compare executive function differences among ADHD subtypes in children with SBH.
- To examine executive function differences between children with SBH and controls.
Main Methods:
- Utilized parent rating scales to identify ADHD and its subtypes.
- Employed cognitive measures to assess executive functions.
- Compared executive function profiles using multivariate and univariate tests, including the Behavior Rating Inventory of Executive Function (BRIEF).
Main Results:
- 31% of children with SBH met criteria for ADHD, predominantly the Inattentive type (23%).
- Children with SBH showed executive function deficits compared to controls.
- Significant differences in executive function ratings were found between SBH children with and without ADHD, and between ADHD Combined and Predominantly Inattentive subtypes.
Conclusions:
- The incidence of ADHD in children with SBH is higher than the general population rate.
- ADHD in SBH is characterized more by inattention than hyperactivity or impulsivity.
- While some executive function differences exist between ADHD subtypes in SBH, they require further clarification, similar to non-brain-injured populations.
Abstract:
This study addressed the incidence of Attention-Deficit/Hyperactivity Disorder (ADHD) subtypes in children with spina bifida meningomyelocele and shunted hydrocephalus (SBH) as well as differences in executive functions among these subtypes. Parent rating scales revealed that 31% of the group with SBH could be identified with AD/HD, mostly the Inattentive type (23%). The group with SBH differed from normal controls on cognitive measures of executive functions, but subtype differences were not significant. Multivariate tests showed that children with SBH were rated with greater difficulties on the Behavior Rating Inventory of Executive Function (BRIEF) compared to controls; those with SBH and any subtype of ADHD differed from those with SBH and no ADHD; and those with ADHD (Combined Type) differed significantly from those with ADHD (Predominantly Inattentive Type). Subtype differences on univariate tests in the latter comparison were significant on the BRIEF Inhibit scale, showing more disinhibition in those with SBH and ADHD (Combined Type), but no significant differences were apparent on the BRIEF Sustain, Shift, and Initiate scales. The results show that the incidence of ADHD in children with SBH exceeds the population rate, is represented by problems with inattention rather than with impulsivity and hyperactivity; and that as with non-brain injured individuals, subtype differences in cognitive function remain to more clearly delineated.
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