SPINAL LESION LEVEL, SHUNT STATUS, FAMILY RELATIONSHIPS, AND PSYCHOSOCIAL ADJUSTMENT IN CHILDREN AND ADOLESCENTS WITH SPINA-BIFIDA MYELOMENINGOCELE

Investigated whether family functioning and child psychosocial adjustm ent were associated with spinal lesion level and shunt status in 65 ch ildren and adolescents with spina bifida myelomeningocele (age range = 8-16). Mothers of children with higher lesion levels (i.e,, thoracic level) reported more attachment to their children, less family conflic t, and a greater willingness to grant autonomy to their offspring, Suc h findings support a ''marginality'' interpretation of the data, insof ar as the least physically impaired children with spina bifida exhibit ed the greatest family difficulties. Based on maternal report, childre n with shunts performed more poorly in school and exhibited lower leve ls of cognitive competence than children without shunts, Findings are discussed in relation to literatures on neuropsychological functioning and psychosocial adjustment in children with spina bifida.