Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)




Objective: Despite research documenting social dysfunction in youth with spina bifida (SB), little is known about the etiology of these social difficulties; most investigations identifying predictors of social deficits have concentrated exclusively on one domain. This longitudinal study examines the relative predictive power of neurocognitive (attention and executive function), family (cohesion and conflict), and health-related (body mass index, condition severity) variables on later social skills in youth with SB.

Methods: 112 youth with SB (T1 mean age = 11.19 years) and their families participated in study visits two years apart. Study variables were assessed by multiple methods (questionnaire, medical chart review, observed family interactions, observed peer interactions, neurocognitive tests) and reporters (parents, teachers). Hierarchical linear regressions with demographic covariates were conducted to determine the relative predictive power of the three domains on T2 social skills.

Results: Observed social skills at T2 were predicted by neurocognitive variables, while both the family and health-related domains yielded nonsignificant values; neurocognitive tests and observed family conflict accounted for significant variance in observed T2 social skills. The associations between the neurocognitive and family domains with T2 teacher-reported social skills attained marginal significance, with neurocognitive tests and observed family cohesion being the strongest individual predictors. Parent-reported social skills were not predicted by any of the study variables.

Conclusions: Neurocognitive variables accounted for the most variance in later social skills, while family variables were the next strongest predictors. Results differed based on the method and reporter used to assess social skills. To maximize effectiveness, social skills interventions may address attention and executive function as well as family interactions.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.