Adolescent development and family functioning in youth with spina bifida.

The purpose of this article is to review research concerning adolescent development and family functioning among youth with spina bifida myelomeningocele (SBM). Adolescence is a developmental period characterized by substantial changes in biological, psychological, and social functioning, as well as transformation and reorganization within the family system. A biopsychosocial-contextual model of development was utilized to describe the interface between normative adolescent development and the experience of a chronic health condition among youth with SBM. Major empirical findings relevant to family functioning in adolescents with SBM are presented, including the family environment, parenting behaviors, and marital and parental functioning. There is variability with regards to the influence of SBM on the family system and research identifies both disruption and resilience in families. Current research suggests that families of youth with SBM may have higher levels of family stress, difficulties with family roles, lower levels of cohesion, less adaptive parental control and overprotection, and a greater risk for child and parental psychosocial adjustment difficulties. The review concludes with a discussion of the clinical implications of these findings for the care of youth with SBM and directions for future research.