Cognition in spina bifida and its consequences for everyday life in a life-span perspective -A systematic review

Introduction Persons with Spina Bifda (SB) has been described as having low independence and participation restriction in society regardless of inclusion policies. Traditional efforts for this group has mainly focused on the... [ view full abstract ]

Introduction Persons with Spina Bifda (SB) has been described as having low independence and participation restriction in society regardless of inclusion policies. Traditional efforts for this group has mainly focused on the physical disability despite the emerging knowledge that SB also is associated with cognitive dysfunctions.
Aim To describe knowledge, as expressed in scientific publications, on cognitive characteristics in children, youths and adults with spina bifida and its consequences for everyday functioning, development and learning in a life time perspective.
Method Systematic data-base search and quality assessment of articles on cognition and everyday functioning produced from 2000 and forward. 67 were relevant according to the McMaster Rating of Evidence.
Results: Cognitive dysfunction was found to be hindering in all domains of everyday-life in the International Classification of Functioning and Health (ICF). Difficulties with planning and initiation were the most hindering factors for autonomy.
About 70% have an intellectual function above an IQ of 70. Difficulties in visual perception, attention and memory function and executive problems with planning and initiation were described as common despite IQ-level. The difficulties still remain into adulthood.
Conclusions: Knowledge about cognitive profile and its profound impact on independence and participation is crucial to provide optimal habilitation for persons with spina bifida. Throughout life they need support to overcome especially executive dysfunctions in daily life. This knowledge is fundamental and indicate that OT:s must shift focus from primarily motor based interventions to an occupation centered perspective in which cognitive based intervention’s combined with motor based is possible.