Before we started the Chicago Healthy Adolescents Transition Study, we did a smaller study on children with Spina Bifida. We'd like to share some of our results with you. Our overall goal in conducting this earlier study was to better understand how families protect their children from difficulties during the late childhood and early adolescent developmental periods.

What did we find? Interestingly, parents and children in 67 families with children who have spina bifida tended to get along with each other better than did families with able-bodied children. Families with children who have spina bifida also tended to report fewer family conflicts. These findings suggest that the family atmosphere is better for children with spina bifida than in families with able-bodied children.

On the other hand, other comparisons between these groups suggest that children with spina bifida tend to get lower school grades than their ale-bodied peers and tend to have lower self-esteem. Also, children with spina bifida are involved in family decision making less then able-bodied children. These findings would suggest that children would benefit from as much decision-making responsibility as they can handle. Parents may also want to be attentive to signs of poor self-esteem in their children.

We also looked at whether there were differences between children with different lesion levels. Interestingly, we found that mothers of children with higher lesion levels (a more severe physical disability) reported better relationships with their child and less family conflict. In other

words, it is not the case that children with more severe disabilities have more severe problems. We also found that children with shunts tend to perform more poorly in school than children without shunts.

Finally, we found that certain behaviors of children with spina bifida may be "red flags" that the child is having difficulties. We found that children who cope by spending time alone or who blame themselves for all their problems are more at risk for adjustment difficulties.