A. Jennekens-Schinkel

Cognitive status of young adults with spina bifida

The cognitive status of 168 Dutch young adults (103 females, 65 males; mean age 20 years 9 months, age range 16 to 25 years) with spina bifida (SB) was examined. The main purpose was to establish the effect of the type of SB (occulta or aperta) and the effect of hydrocephalus (HC) within the group with SB aperta (AHC+). Results indicated, on average, a lower cognitive status of persons with AHC+ (n=111) than of persons with SB occulta (n=37) and of persons with SB aperta without HC (AHC-; n=20). Almost half the young adults with AHC+ had cognitive impairments of some sort. These included more domain specific impairments (70%) as well as a more general cognitive deficit (30%). Cognitive status of persons with SB occulta and of those with AHC- was similar to that in the healthy population. The presence of associated pathology, rather than SB per se, has a negative effect on cognitive status.

Life satisfaction of young adults with spina bifida

This study concerns life satisfaction and its determinants in Dutch young adults with spina bifida (SB). Data on life satisfaction (Life Satisfaction Questionnaire [LiSat‐9]) were related to hydrocephalus, lesion level, disabilities, and demographic variables. In total, 179 young adults with SB participated (41% male, age range 16‐25y; 79% SB aperta, 67% hydrocephalus [HC], 39% wheelchair‐dependent). Most were satisfied with their life as a whole (24% dissatisfied). No difference was found from a population reference group (28% dissatisfied). Highest proportions of dissatisfaction were found for financial situation (44%), partnership relations (49%), and sex life (55%). Least dissatisfaction was found for contact with friends (17%) and families (15%). Young adults with SB and HC were more satisfied with their financial situation and family life but were less satisfied with self‐care ability and partnership relations than those without HC and the reference group. However, except for self‐care ability, relationships between life satisfaction and having SB were weak. In conclusion, self‐care ability and partnership relations were rated least favourable and may need more attention from care providers. Overall, SB does not seem to be an important determinant of life satisfaction.

Shame and guilt in children: Differential situational antecedents and experiential correlates.

Situational antecedents and experiential correlates of shame and guilt in children were examined by having 6-11-year-olds give ratings of the extent to which two types of situations would elicit a protagonists feelings of shame and guilt. It was predicted that one type of situation should elicit both shame and guilt, because the protagonist caused harm to another person by behaving incoherently or incompetently. The other type of situation was predicted to elicit more shame than guilt, because the protagonist behaved incoherently or incompetently without causing harm to anyone. Two types of questions were used to elicit childrens ratings: in term-based questions the emotion terms ‘guilt’ and ‘shame’ were used, while in correlate-based questions guilt and shame were alluded to by citing experiential correlates of these emotions. Children aged 9 and upward differentiated between both types of situations and between judgments of shame vs. guilt, both when giving term-based and when giving correlate-based ratings. There were no systematic differences in childrens performance depending on whether they gave correlate-based or term-based judgments.

Attention deficits are not characteristic of schoolchildren with newly diagnosed idiopathic or cryptogenic epilepsy.

 Purpose: To compare problems of attention in schoolchildren with newly diagnosed idiopathic or cryptogenic epilepsy with those in healthy classmates.

Restrictions in social participation of young adults with spina bifida

Purpose. To determine participation restrictions of young adults with spina bifida (SB) in relation to health condition and activity limitations. Method. A total of 179 persons aged 16–25 years and born with SB participated in a cross-sectional study. The main outcome on four domains of participation (independent living, employment, education and partner relationships) was assessed using a structured questionnaire. Results. At the mean age of 21 years only 16% were living independently, more than one-third of the participants went to special secondary education, 53% of those who finished education did not have a regular job and 71% did not have a partner. Health condition variables (type of SB, hydrocephalus and level of lesion) and to a lesser extent activity limitations (wheelchair dependence and incontinence) were significant determinants for having participation restrictions. Perceived hindrances in participation included long-distance transportation (19–36%), accessibility (10–42%), physical impairments (22–40%), emotional barriers (20–32%) and financial limits (3–17%). More severe SB, defined as hydrocephalus, high level of lesion and wheelchair dependence, was related with more experienced hindrances due to long-distance transportation accessibility of buildings. Conclusions. Many young adults with spina bifida experience participation restrictions. Severity of SB was negatively related to participation. Social integration should be a major focus in the professional guidance of youngsters with physical disabilities.

Learning and memory of school children with epilepsy: a prospective controlled longitudinal study

The aim of the study was to determine whether learning and memory are compromised in school children with recently diagnosed idiopathic and/or cryptogenic epilepsy and to study relationships between learning and memory and psychosocial and epilepsy variables. Word span and learning of locations were assessed within 48 hours after diagnosis of epilepsy and three and 12 months later, in 69 school children with epilepsy (aged 9.1 years, SD 2.7; 33 males, 36 females) and 66 classmates. Results showed that patients and controls performed similarly in registration, recall, and retention. Patients recalled slightly less than controls when probed under conditions of increased demand on working memory. Maladaptive reactions of parents and children to the onset of epilepsy and not reaching 6-months of seizure remission contributed to poor performance. Individually, those patients who required special assistance at school, under-performed occasionally in one or the other component of memory. Although the proportion of under-performers was stable over time, the children composing the group did change. It was concluded that school children with new onset idiopathic or cryptogenic epilepsy are inordinately vulnerable when processing memory tasks. The vulnerability is neither persistent nor memory-specific.

Negative emotions in children with newly diagnosed epilepsy.

Summary: Purpose: To understand the emotional predicament in children with recently diagnosed idiopathic or cryptogenic epilepsy.

Visual, cognitive, and neurodevelopmental outcome at 5½ years in children with perinatal haemorrhagic-ischaemic brain lesions

To determine predictive values of early visual and neurocognitive assessment in children with perinatally acquired haemorrhagic or ischaemic brain lesions selected on the basis of ultrasound, 63 children (37 boys, 26 girls), who had been followed and examined until the age of 18 months, were reexamined at 5½ years. Good correlations between visual and neurodevelopmental assessments at 18 months and at 5½ years were found. When ultrasound abnormalities were combined with early visual and neurocognitive assessment data, good predictive values, especially for the group of children who had grade 2 to 4 leukomalacia, were found for visual acuity and neurodevelopment.

Set-shifting in healthy children and in children with idiopathic or cryptogenic epilepsy

Set‐shifting is an important aspect of attention and regulation of behaviour. The ability of young children to shift set is debated. Set‐shifting is usually examined using sorting tasks that are designed for adults and hence are inadequate for children. In this study, an experimental Sorting Task for Children (STC) is administered to 54 healthy children (aged 4 to 10 years) and compared with a widely used adult sorting task, the Modified Card Sorting Test. This experiment shows that preschool children are capable of set‐shifting. An extensive error analysis of the STC reveals that perseverations are not predominant. Hence, set‐shifting in young children may be characterised by ‘trial and error’ rather than by being stuck in a mental set, which is suggested to be typical of adults with frontal lobe damage. A pilot study of 10 children with idiopathic or cryptogenic epilepsy shows unstable set‐shifting rather than inability to shift set, which is concordant with known problems in regulation of behaviour.

Variables in childhood epilepsy and scholastic underachievement.

We complimentDr.Fastenauetal.(2004)ontheirbeau-tifulelucidationoffamilyfactorsthatmoderatetheimme-diate effect of neuropsychological functioning and schoolachievement of children with epilepsy (1). Indeed, thetype of theoretical and practical framework as used bythe authors enables one to disentangle the decisive fac-tors, enhances our understanding of the functioning ofschoolchildren with epilepsy, and yields a sound basis forcounseling. In other illness groups, such as spina bifida,a similar theoretical and statistical approach has alreadyproven to be of great value [see, for instance, Holmbecket al., 1997 (2)].Dr. Fastenau et al. applied exploratory factor analysisto achieve data reduction and to identify relevant con-structs in their neuropsychological test findings. In thisrespect, we wish to compliment the authors’ review ofthe literature. In the segment of the population of chil-dren with epilepsy that is similar to that described by Dr.Fastenau et al. (i.e., children with idiopathic or crypto-genic epilepsy), our group studied performances of thechildren and their parents’ and teachers’ complaints withrespect to the behavior of the children, by using prin-cipal component analysis. We found ≥70% of the vari-ance explained by five factors covering major domains ofneuropsychological functioning (3). We strived for max-imal homogeneity of our patient sample (i.e