Friedman Deborah, Holmbeck Grayson N, DeLucia Christian, Jandasek Barbara, Zebracki Kathy
Child and Adolescent Psychiatry, Massachusetts General Hospital, USA.
Rehabil Psychol. 2009 Feb;54(1):16-27. doi: 10.1037/a0014279.
The current study investigated individual growth in autonomy development across the adolescent transition, comparing the trajectories of children with and without spina bifida.
Individual growth curve modeling procedures were utilized to describe the developmental course of autonomy across four waves of data collection, from ages 9 to 15, and to test whether illness status [spina bifida vs. matched comparison group (N = 68 for both groups at Time 1)] would significantly predict individual variability in autonomy development. Potential moderators [child gender, SES, and Peabody Picture Vocabulary Test (PPVT) score] of the association between illness status and autonomy development were also examined.
Children with spina bifida demonstrated distinct developmental trajectories, though the nature of the group differences varied by type of autonomy development (emotional vs. behavioral), context (i.e. school vs. family), and reporter. Significant interactions with PPVT score and child gender were found.
Overall, children with spina bifida show considerable developmental resiliency, but may lag behind their peers in specific areas of autonomy. Boys with spina bifida, and children with spina bifida who have lower than average levels of verbal intelligence, appear to be at greater risk for exhibiting delays in autonomy development.
本研究调查了青少年过渡阶段自主性发展的个体成长情况，比较了患有和未患有脊柱裂儿童的发展轨迹。
采用个体成长曲线建模程序来描述从9岁到15岁四个数据收集阶段自主性的发展过程，并检验疾病状态[脊柱裂与匹配对照组（两组在时间1时均为N = 68）]是否能显著预测自主性发展的个体差异。还研究了疾病状态与自主性发展之间关联的潜在调节因素[儿童性别、社会经济地位和皮博迪图片词汇测验（PPVT）分数]。
患有脊柱裂的儿童表现出不同的发展轨迹，尽管群体差异的性质因自主性发展类型（情感与行为）、背景（即学校与家庭）和报告者而异。发现与PPVT分数和儿童性别存在显著交互作用。
总体而言，患有脊柱裂的儿童表现出相当的发展弹性，但在自主性的特定领域可能落后于同龄人。患有脊柱裂的男孩以及言语智力低于平均水平的患有脊柱裂的儿童，在自主性发展方面出现延迟的风险似乎更大。
