Spina bifida-myelomeningocele (SBH), a neuroembryogenic defect of neural tube closure associated with deformities of the spine and brain is associated with motor, non-verbal cognitive, attention, language, and adaptive behavior problems. While these deficiencies are well documented, their developmental origins are not well understood since to date few studies have examined cognitive development for children with SBH in the infancy and preschool periods. We have previously found that children with SBH have specific deficits in areas of behavioral regulation, responding efficiently to rule-based learning tasks, and organizing and initiating a behavioral response without high degrees of external structure from others. These are referred to as integration of information and contingency learning (II/CL) skills. Since deficits in II/CL skills may underlie some of the more general problems that children with SBH exhibit, we will examine II/CL skills in the infancy and preschool period. The II/CL skills examined in this study have direct conceptual links with the later measure examined in the studies being conducted in Project 5. The proposed research will examine longitudinally four II/CL abilities for 60 children with SBH and 60 normal control children, comparable on socioeconomic status (SES) and gender, across four timepoints (12, 18, 26, and 36 months). These four II/CL abilities include contingency learning skills, goal directed play, social initiative, and social responsiveness. Measuring growth across four age points will allow for the evaluation of complex patterns of development. We expect that core deficits associated with SBH, early abilities, and specific brain anomalies will influence the development of II/CL skills. Core deficits in motor exploration, motor timing, and attention shifting will be examined as predictors of early abilities, namely motor contingencies, spatial learning, and joint-attention, both of which will be examined in 7 months. Early abilities are in turn expected to predict growth in later II/CL skills. Concurrent maternal (maintaining infants' attentional focus, contingent responsiveness, control restrictiveness) and child (motor and language abilities) influences will also be examined for their potentially ameliorating influence on the II/CL skills from 12 through 36 months of age. We expect that rates of growth in the II/CL abilities will predict children's independent problem solving and integration of information skills (self control, procedural learning, linguistic flexibility, and self-help skills) and standardized measures of mental, language, and visual-motor skills at 36 months. Given the link of II/CL skills to the development of daily living skills, social relationships, and academic performance it is important to understand the origins of these skills and their implications for children with SBH.
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