Generalizability of WISC-IV index and subtest score profiles in children with traumatic brain injury

The Wechsler Intelligence Scale for Children, 4th edition (WISC-IV) is often used to assess children with traumatic brain injury (TBI); although limited information is available regarding its psychometric properties in these children. Two recent reports suggest that the Perceptual Reasoning Index is not uniquely sensitive to TBI, which differs from the Perceptual Organization Index of the WISC-III. The current study examined WISC-IV profiles in two independently gathered samples of children with TBI. Examination of profiles indicated similarities between the current findings and those reported in other studies, in that the greatest deficits were present on the Processing Speed Index and its component subtests of Coding and Symbol Search, while the Perceptual Reasoning index score was comparable to the Verbal Comprehension Index. Also, no significant index or subtest score differences were present when the current sample was compared to the children with TBI reported by Allen, Thaler, Donohue and Mayfield (2010 Allen, D. N., Thaler, N. S., Donohue, B. and Mayfield, J. 2010. WISC-IV profiles in children with traumatic brain injury: Similarities to and differences from the WISC-III. Psychological Assessment, 22(1): 57–64. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). The present findings are consistent with two prior studies of the WISC-IV in children with TBI, providing additional evidence for profile differences between the WISC-III and WISC-IV. The results also suggest that WISC-IV profiles reported in prior studies are generalizable across TBI samples and study sites.     

Recovery in Memory Function,and its Relationship to Academic Success,at 24 Months Following Pediatric TBI*

While a number of research papers have reported findings on memory deficits following traumatic brain injury (TBI), only limited studies have monitored the recovery of these skills over time. The present study examined memory ability and its effect on academic success in a group of children who had sustained a mild, moderate, or severe traumatic brain injury (TBI). Results showed that the severe TBI group exhibited greater deficits on memory tasks, irrespective of modality, in the acute, 6-, 12-, and 24-month postinjury stages, in comparison to mild and moderate TBI groups. Performance on academic measures was dependent on both injury severity and task demands. Preinjury academic ability and verbal memory indices best predicted academic success.     

Construct and Criterion Validity of the Comprehensive Trail Making Test in Children and Adolescents with Traumatic Brain Injury

The current study examined the construct and criterion validity of the Comprehensive Trail Making Test (CTMT) when used to evaluate children and adolescents with traumatic brain injury (TBI). Participants included 100 children and adolescents, 50 who had sustained TBI and 50 normal comparisons (NC). Analyses indicated that the CTMT factor scores were significantly correlated with tests of perceptual organizational ability, processing speed, and motor function and provided support for its construct validity. Additionally, correlations between the various CTMT scores suggested that a different pattern of associations was present in the TBI group compared to the NC group. Finally, the TBI group performed significantly worse (p < .001) on all of the CTMT scores, including each of the five CTMT trails as well as the factor and composite index scores. Results support the construct and criterion validity of the CTMT when used to assess children and adolescents with TBI.     

Referential cohesion and logical coherence of narration after closed head injury

A group with closed head injury was compared to neurologically intact controls regarding the referential cohesion and logical coherence of narrative production. A sample of six stories was obtained with tasks of cartoon-elicited story-telling and auditory-oral retelling. We found deficits in the clinical group with respect to referential cohesion, logical coherence, and accuracy of narration. The occurrence of deficits depended on the condition of narrative production and, to some extent, on the particular story used. The primary implications of this study pertain to the attention given by researchers to the feature of discourse production being studied and processing demands of the task.     

The long-term effects of mild head injury on short-term memory for visual form, spatial location, and their conjunction in well-functioning university students

Research has suggested the presence of subtle long-term cognitive changes in otherwise well-functioning individuals who have previously sustained a mild head injury (MHI). This paper investigated the long-term effects of MHI on visual, spatial, and visual-spatial short-term memory in well-functioning university students. Sixteen students who reported having sustained a MHI were compared to 16 controls on tests of short-term memory (STM) for abstract polygons in haphazardly arranged locations. The three tests differed only in the requirements for recall (shapes for the visual task, locations for the spatial task, and the shapes in their respective locations for the visual-spatial task). MHI participants were selectively impaired on spatial memory, suggesting that tasks of spatial STM may be more sensitive, compared to tasks of visual STM, to the subtle long-term cognitive changes that may be present after a MHI.     

Neuropsychological function in a group of patients 25 years after sustaining minor head injuries as children and adolescents

Previous studies suggest that neuropsychological impairment following mild to moderate pediatric head injury may become persistent and interrupt the normal course of intellectual development. In this study 45 subjects were assessed with a standardized neuropsychological test battery 25 years after sustaining mild to moderate head injury as children. Although the group scores in the normal range, significant relations between head injury severity and current neuropsychological function were found. The most important predictor of poor outcome was length of PTA at injury, EEG pathology, and loss of consciousness at injury. No significant influence of pre- and post-injury risk factors on current neuropsychological function was evident. The findings support the view that complicated mild and moderate paediatric head injury may heighten the risk of developing subtle neuropsychological problems later in life.     

Imagination after neurological losses of movement and sensation: The experience of spinal cord injury

To what extent is imagination dependent on embodied experience? In attempting to answer such questions I consider the experiences of those who have to come to terms with altered neurological function, namely those with spinal cord injury at the neck. These people have each lost all sensation and movement below the neck. How might these new ways of living affect their imagination?     

Understanding text after severe closed-head injury: assessing inferences and memory operations with a think-aloud procedure

A think-aloud method was used to examine the content of information available to working memory during narrative comprehension in a CHI population. Twenty severe CHI participants (>1 year post-injury) and 20 controls talked aloud after they read each sentence of story narratives. Trabasso and Magliano's (1996a) verbal protocol analysis was then used to code for the production of inferential and non-inferential clauses and the memory operations that supported inferential clause production. We found that CHI and control groups produced a comparable number of clauses, that inferences dominated narrative comprehension, and that both groups produced more explanatory inferences than predictive or associative inferences. Despite these qualitative similarities, the CHI group demonstrated poorer comprehension, generated proportionately fewer inferences, relied less on retrieval as a memory source for explanatory inferences, and produced more non-inferential clauses and associative inferences.     

Sensory sensitivity after acquired brain injury: A systematic review

Patients with acquired brain injury frequently report experiencing sensory stimuli as abnormally under- (sensory hyposensitivity) or overwhelming (sensory hypersensitivity). Although they can negatively impact daily functioning, these symptoms are poorly understood. To provide an overview of the current evidence on atypical sensory sensitivity after acquired brain injury, we conducted a systematic literature review. The primary aim of the review was to investigate the behavioural and neural mechanisms that are associated with self-reported sensory sensitivity. Studies were included when they studied sensory sensitivity in acquired brain injury populations, and excluded when they were not written in English, consisted of non-empirical research, did not study human subjects, studied pain, related sensory sensitivity to peripheral injury or studied patients with a neurodegenerative disorder, meningitis, encephalitis or a brain tumour. The Web of Science, PubMed and Scopus databases were searched for appropriate studies. A qualitative synthesis of the results of the 81 studies that were included suggests that abnormal sensory thresholds and a reduced information processing speed are candidate behavioural mechanisms of atypical subjective sensory sensitivity after acquired brain injury. Furthermore, there was evidence for an association between subjective sensory sensitivity and structural grey or white matter abnormalities, and to functional abnormalities in sensory cortices. However, further research is needed to explore the causation of atypical sensory sensitivity. In addition, there is a need for the development of adequate diagnostic tools. This can significantly advance the quantity and quality of research on the prevalence, aetiology, prognosis and treatment of these symptoms.     

DECREASING DANGEROUS INFANT BEHAVIORS THROUGH PARENT INSTRUCTION

One adult and three adolescent mothers with 1-year-old infants were taught to reduce their infants' potential for injury in the home. After being taught to increase their positive interactions with their infants, the mothers were taught to child-proof the home, to use playpen time-out for potentially dangerous behaviors, and to give positive attention for safe behaviors. A multiple baseline design across subjects was used to evaluate functional control. Potentially dangerous behaviors, observed during 10 min of free play, decreased from variable and, at times, high rates during baseline to stable near-zero rates after treatment. These target behaviors remained low at a 7-month follow-up assessment.