Cognitive, behavioural and educational outcomes in children aged 5-11 years with Spina Bifida in Northern Ireland

  • Yogesh Parajuli

Student thesis: Doctoral Thesis


Background: While the survival of children born with Spina Bifida has improved, some may have lower cognitive, behavioural and educational
performance. Currently, little is known on these outcomes for children of primary school age assessed by multi informants i.e. parents/ guardians in the home environment and teachers in the school environment.

Aim: To investigate the effect of Spina Bifida on cognitive, behavioural and educational outcomes in 5-11year olds in Northern Ireland.

Method: A cross-sectional study design of children with Spina Bifida, recruited from the Shine (Spina Bifida, Hydrocephalus, Information, Networking, Equality) database, and children without Spina Bifida with similar date of birth,
of same gender and in the same class as the child with Spina Bifida. Data were collected from parents/guardians and teachers using Behavior Rating Inventory of Executive Function, second edition (BRIEF2) - to assess cognitive outcomes, Strengths and Difficulties Questionnaire (SDQ) - to assess behavioural outcomes and Teacher Academic Attainment Scale (TAAS) - to
assess academic outcomes.

Results: Nineteen parental and 13 teacher responses were received for children with Spina Bifida, and eight parental and seven teacher responses for children without Spina Bifida. 68% of children with Spina Bifida and 88% of children without Spina Bifida were female. Children in both groups performed at a similar level across subscales of BRIEF2 with the exception of Working Memory from both parent report and teacher report. No group differences
were found in SDQ scales as assessed by parents; teacher assessment of conduct problems, hyperactivity/inattention and peer problems were higher for children with Spina Bifida. Anticipated matched analysis was not possible due to unequal number of participants between the groups. Children with Spina Bifida performed similarly in all subjects across the curriculum with the exception of English, Mathematics and History.

Conclusions: Based on this small sample, a potential need for evidence-based interventions to assist children with Spina Bifida in the cognitive area of Working Memory and also in English, Mathematics and History is postulated.
Larger longitudinal studies are required to confirm these findings.
Date of AwardSept 2021
Original languageEnglish
SupervisorKaren Casson (Supervisor), Maria Loane (Supervisor) & Victoria Simms (Supervisor)


  • Spina bifida
  • Cognition
  • Behaviour
  • Education

Cite this