Nonverbal learning disabilities and adults with spina bifida: Differentiating subgroups based on higher order cognitive skills and family environment

Date of Completion

January 1996


Psychology, Psychobiology|Health Sciences, Rehabilitation and Therapy|Psychology, Developmental|Psychology, Clinical




Studies that have attempted to characterize the neuropsychological and cognitive characteristics associated with spina bifida indicate that, for a majority of persons with spina bifida and hydrocephalus (SBH), patterns of cognitive strengths and weaknesses may be consistent with Rourke's description of nonverbal learning disabilities (NLDs). In fact, professionals who treat persons with spina bifida are now frequently basing their assumptions about cognitive patterns among these patients on the NLD model and are disseminating information based on the NLD model to affected persons and other professionals.^ Rourke's model is based on the premise that persons with NLD will exhibit impaired lower cognitive level nonverbal skills, such as visuospatial perception, and that these impaired skills are the foundation of a linear, causal path that ends with impaired higher level cognitive skills and, ultimately, dismal prospects for employment and/or vocational success.^ Although earlier spina bifida research supports the premise of nonverbal weaknesses relative to verbal skills in persons with spina bifida, the Rourke model has not been tested on adult samples of persons with SBH.^ In order to ascertain whether or not the NLD model, including predictions of poor vocational outcome, apply to a sample of persons with spina bifida, 38 adults with spina bifida were administered a battery of intelligence, neuropsychological, and self-report tests. The group data were then compared to Rourke samples. Results indicated that the spina bifida group, as a whole, did meet the criteria for nonverbal learning disabilities. However, the subgroups that were most equivalent to Rourke's NLD data were subgroups of persons with spina bifida who had sustained employment and who held relatively high job levels. Neuropsychological, global intellectual, and medical variables were not associated with vocational outcome. Family environment, as it was measured, was only weakly associated with vocational success. Years of education was the strongest predictor of vocational outcome, both for those who with sustained employment and in predicting higher job levels. Implications of these findings in terms of future research and programmatic planning for persons with spina bifida are discussed. ^