INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #30 Executive Functioning Predictors of the Transition from Pediatric to Adult Healthcare in Young Adults with Spina Bifida Allison Payne, Loyola University Chicago, Chicago, United States Tessa Kritikos, Loyola University Chicago, Chicago, United States Olivia Clark, Loyola University Chicago, Chicago, United States Taylor Hilderbrand, Loyola University Chicago, Chicago, United States Grayson Holmbeck, Loyola University Chicago, Chicago, United States Category: Medical/Neurological Disorders/Other (Child) Keyword 1: spina bifida Keyword 2: executive functions Objective: The transition from pediatric to adult healthcare is an important process for individuals with chronic health conditions, such as spina bifida (SB). Extant literature has highlighted the role of neuropsychology and potential impact of executive functioning on this transition in sickle cell disease, epilepsy, pediatric brain tumor, and solid organ transplant (Heitzer et al., 2020; Smith et al., 2021; Turner et al., 2023; Wills et al., 2010). Individuals with SB are at increased risk of executive functioning deficits, which may hinder the transition from multidisciplinary pediatric care to segmented adult care. SB transition guidelines and models have incorporated executive functioning (Fremion & Dosa, 2019; Holmbeck et al., 2021), but no research has examined the relationship between executive functioning and transition outcomes. Therefore, this study aims to examine executive functioning as a predictor of the transition from pediatric to adult healthcare. Participants and Methods: Participants included 140 adolescents/young adults with SB (Time 4: M_age= 17.61 years; Time 6: M_age = 23.02 years, 40.7% female) participating in a six-wave longitudinal study. Participants completed visually- and verbally-based tasks of executive functioning at Time 4 (D-KEFS Design Fluency and Color Word Interference). Participants completed a questionnaire-based measure of executive dysfunction (BRIEF-A), transition readiness questionnaire (SickKids Transition Readiness Checklist for Patients), and healthcare transition interview at Time 6. Transition interview outcomes included primary and specialist provider types (pediatric versus adult/lifespan), history of transition meeting (meeting with at least one health professional to discuss transition), and subjective report of transition status. Covariates included lesion level and socioeconomic status (collected at Time 1) and age (collected at Times 4 and 6). Results: Self-reported working memory problems significantly predicted transition readiness, with more working memory difficulties predicting lower levels of transition readiness (ΔR² = .042, p = .045). Self-reported planning/organizing problems significantly predicted whether young adults had a transition meeting. Findings were in the unexpected direction, with young adults with more planning/organizing problems being more likely to have had a transition meeting (X² = 11.055, p < .001). Better visually-based executive functioning skills predicted greater transition readiness (ΔR² = .077, p = .012) and having more adult/lifespan specialist providers (R² = .070, p = .032). Conclusions: Findings suggest that self-reported working memory and planning/organizing problems and performance on visually-based executive functioning tasks are associated with healthcare transition outcomes. While findings were generally in the expected direction, with better executive functioning predicting better transition outcomes, young adults with more planning/organizing problems were more likely to have had a transition meeting. This may reflect that individuals with greater planning/organizing challenges may receive additional support from caregivers and providers in arranging a transition meeting. Future research should consider informant-based reports of executive functioning and the mediating role of transition readiness in the relationship between executive functioning and transition outcomes. Furthermore, SB research should continue to emphasize the role of executive functioning in the transition to adult healthcare, as identification of executive dysfunction may aid with allocation of resources and interventions to support successful transition in SB.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #30

Executive Functioning Predictors of the Transition from Pediatric to Adult Healthcare in Young Adults with Spina Bifida

Allison Payne, Loyola University Chicago, Chicago, United States
Tessa Kritikos, Loyola University Chicago, Chicago, United States
Olivia Clark, Loyola University Chicago, Chicago, United States
Taylor Hilderbrand, Loyola University Chicago, Chicago, United States
Grayson Holmbeck, Loyola University Chicago, Chicago, United States

Category: Medical/Neurological Disorders/Other (Child)

Keyword 1: spina bifida
Keyword 2: executive functions

Objective:

The transition from pediatric to adult healthcare is an important process for individuals with chronic health conditions, such as spina bifida (SB). Extant literature has highlighted the role of neuropsychology and potential impact of executive functioning on this transition in sickle cell disease, epilepsy, pediatric brain tumor, and solid organ transplant (Heitzer et al., 2020; Smith et al., 2021; Turner et al., 2023; Wills et al., 2010). Individuals with SB are at increased risk of executive functioning deficits, which may hinder the transition from multidisciplinary pediatric care to segmented adult care. SB transition guidelines and models have incorporated executive functioning (Fremion & Dosa, 2019; Holmbeck et al., 2021), but no research has examined the relationship between executive functioning and transition outcomes. Therefore, this study aims to examine executive functioning as a predictor of the transition from pediatric to adult healthcare.

Participants and Methods:

Participants included 140 adolescents/young adults with SB (Time 4: M_age= 17.61 years; Time 6: M_age = 23.02 years, 40.7% female) participating in a six-wave longitudinal study. Participants completed visually- and verbally-based tasks of executive functioning at Time 4 (D-KEFS Design Fluency and Color Word Interference). Participants completed a questionnaire-based measure of executive dysfunction (BRIEF-A), transition readiness questionnaire (SickKids Transition Readiness Checklist for Patients), and healthcare transition interview at Time 6. Transition interview outcomes included primary and specialist provider types (pediatric versus adult/lifespan), history of transition meeting (meeting with at least one health professional to discuss transition), and subjective report of transition status. Covariates included lesion level and socioeconomic status (collected at Time 1) and age (collected at Times 4 and 6).

Results:

Self-reported working memory problems significantly predicted transition readiness, with more working memory difficulties predicting lower levels of transition readiness (ΔR² = .042, p = .045). Self-reported planning/organizing problems significantly predicted whether young adults had a transition meeting. Findings were in the unexpected direction, with young adults with more planning/organizing problems being more likely to have had a transition meeting (X² = 11.055, p < .001). Better visually-based executive functioning skills predicted greater transition readiness (ΔR² = .077, p = .012) and having more adult/lifespan specialist providers (R² = .070, p = .032).

Conclusions:

Findings suggest that self-reported working memory and planning/organizing problems and performance on visually-based executive functioning tasks are associated with healthcare transition outcomes. While findings were generally in the expected direction, with better executive functioning predicting better transition outcomes, young adults with more planning/organizing problems were more likely to have had a transition meeting. This may reflect that individuals with greater planning/organizing challenges may receive additional support from caregivers and providers in arranging a transition meeting. Future research should consider informant-based reports of executive functioning and the mediating role of transition readiness in the relationship between executive functioning and transition outcomes. Furthermore, SB research should continue to emphasize the role of executive functioning in the transition to adult healthcare, as identification of executive dysfunction may aid with allocation of resources and interventions to support successful transition in SB.