ArticleArchives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists2025
Healthcare Self-Management, Executive Functioning, and Social Determinants of Health in Young Adults with Pediatric-Onset Disabilities: a Pilot Study.
Article in Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveWe examined the associations of executive functioning and social determinants of health with medical self-management skills in transition-age adults (TAA) with pediatric-onset disabilities.
methodThis cross-sectional pilot study included 47 young adults between the ages of 18-28 and their informants (e.g., parents, partners, siblings). Participants were followed by pediatric rehabilitation clinics for acquired brain injury (ABI = 16), neuromuscular disorders (NMD = 22), or spina bifida (SB = 9). Informants completed the Behavior Rating Inventory of Executive Functions - Adult Version, from which we reported the General Executive Composite. To assess medical self-management, young adult participants completed the Transition Readiness Assessment Questionnaire (TRAQ).
resultsUsing generalized linear regression with the TRAQ as the dependent measure, better informant-rated executive functioning skills were associated with more favorable ratings of healthcare self-management with a large effect size (β = -0.62, p < .001). With a small effect size, there was also a main effect of participant race and ethnicity (β = 0.27, p = .049). Marginalized identities, specifically identification as of Indigenous and Black races, were associated with poorer ratings of healthcare self-management skills.
conclusionsLower executive functioning skills and some marginalized identities are linked to poorer healthcare self-management in this sample of TAA with pediatric-onset disabilities. These findings highlight the value of neuropsychologists in identifying cognitive challenges and implementing targeted interventions in the context of social determinants of health.
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