Abstract
OBJECTIVE: To determine growth in condition-related self-management skill mastery in youth with spina bifida (SB) over time and examine neuropsychological functioning, specifically attention and executive functioning, as a predictor of growth in skill mastery. METHODS: Youth with SB (N = 140; Mage=11.43) completed a neuropsychological assessment, and parents and teachers completed informant-based measures of attention and executive functioning at Time 1 (T1). Parents reported condition-related skill mastery at T1, Time 2 (T2), and Time (T3), with timepoints occurring at 2-year intervals. Linear mixed effects growth curves were utilized to determine change in skill mastery over time with and without neuropsychological functioning predictors. RESULTS: Condition-related self-management skill mastery significantly increased over time across subscales. Attention, working memory, and shifting abilities were significantly associated with self-management skill mastery across subscales at 11.5 years, with better neuropsychological functioning being associated with better skill mastery. Better working memory and shifting abilities at baseline predicted increases in medication skill mastery over time. Contrary to expectations, better attention and planning/organizing abilities at baseline predicted decreases in diet/exercise and catheterization skill mastery over time, respectively. CONCLUSIONS: Youth with SB exhibited gains in condition-related self-management skill mastery over time. Neuropsychological functioning was found to be a stronger predictor of skill mastery at 11.5 years than growth over time, suggesting that youth with better neuropsychological functioning master self-management skills earlier in development. Findings have important implications for clinical monitoring and interventions to support the transfer of medical responsibility and reduce medical nonadherence and secondary health complications.