Implications of family environment and language development: Comparing typically developing children to those with spina bifida

Introduction: This study examines the effect of family environment on language performance in children with myelomeningocele compared with age- and education-matched controls selected from the same geographic region. Methods: Seventy-five monolingual (English) speaking children with myelomeningocele [males: 30; ages: 7-16 years; mean age: 10 years 1 month, standard deviation (SD) 2 years 7 months]and 35 typically developing children (males: 16; ages 7-16 years; mean age: 10 years 9 months, SD 2 years 6 months) participated in the study. The Comprehensive Assessment of Spoken Language (CASL) and the Wechsler tests of intelligence were administered individually to all participants. The CASL measures four subsystems: lexical, syntactic, supralinguistic and pragmatic. Parents completed the Family Environment Scale (FES) questionnaire and provided background demographic information. Standard independent sample t-tests, chi-squared and Fisher's exact tests were used to make simple comparisons between groups for age, socio-economic status, gender and ethnicity. Spearman correlation coefficients were used to detect associations between language and FES data. Group differences for the language and FES scores were analysed with a multivariate analysis of variance at a P-value of 0.05. Results: For the myelomeningocele group, both Spearman correlation and partial correlation analyses revealed statistically significant positive relationships for the FES 'intellectual-cultural orientation' (ICO) variable and language performance in all subsystems (P < 0.01). For controls, positive associations were seen between: (1) ICO and lexical/ semantic and syntactic subsystems; and (2) FES 'independence' and lexical/semantic and supralinguistic tasks. Conclusions: The relationship between language performance and family environment appears statistically and intuitively sound. As in our previous study, the positive link between family focus on intellectually and culturally enhancing activities and language performance among children with myelomeningocele and shunted hydrocephalus remains robust. Knowledge of this relationship should assist parents and professionals in supporting language development through activities within the natural learning environment.