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Donders J, Ramos A. Correlates of performance on the Child and Adolescent Memory Profile (ChAMP) in a mixed pediatric sample. Child Neuropsychol 2024:1-12. [PMID: 38817122 DOI: 10.1080/09297049.2024.2361123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/21/2024] [Indexed: 06/01/2024]
Abstract
This study aimed to determine some of the factors that influence performance on a comprehensive test of verbal and visual memory in children, the Child and Adolescent Memory Profile (ChAMP) in a mixed clinical sample (n = 178; 56% male, 67% White, median age 12 years). We used hierarchical linear regression analyses with ChAMP standard scores as the dependent variable, and parental education as well as Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V) factor index scores as the independent variables. WISC-V Processing Speed and (to a lesser extent) Working Memory were statistically significant predictors of most ChAMP Index scores. In addition, WISC-V Verbal Comprehension contributed to the model for ChAMP Verbal Memory, and WISC-V Visual Spatial to the model for ChAMP Visual Memory. In each case better performance on the WISC-V was predictive of higher scores on the ChAMP, with large effect sizes. WISC-V variables also mediated the positive effect of parental education on ChAMP scores. We conclude that clinicians should consider performance on measures of speed of processing, working memory, language and visual-spatial skills as potential influences on ChAMP results that may suggest a specific memory deficit.
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Affiliation(s)
- Jacobus Donders
- Department of Psychology, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Ashlee Ramos
- Department of Psychology, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
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Feldman SJ, Beslow LA, Felling RJ, Malone LA, Waak M, Fraser S, Bakeer N, Lee JEM, Sherman V, Howard MM, Cavanaugh BA, Westmacott R, Jordan LC. Consensus-Based Evaluation of Outcome Measures in Pediatric Stroke Care: A Toolkit. Pediatr Neurol 2023; 141:118-132. [PMID: 36812698 PMCID: PMC10042484 DOI: 10.1016/j.pediatrneurol.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/08/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
Following a pediatric stroke, outcome measures selected for monitoring functional recovery and development vary widely. We sought to develop a toolkit of outcome measures that are currently available to clinicians, possess strong psychometric properties, and are feasible for use within clinical settings. A multidisciplinary group of clinicians and scientists from the International Pediatric Stroke Organization comprehensively reviewed the quality of measures in multiple domains described in pediatric stroke populations including global performance, motor and cognitive function, language, quality of life, and behavior and adaptive functioning. The quality of each measure was evaluated using guidelines focused on responsiveness and sensitivity, reliability, validity, feasibility, and predictive utility. A total of 48 outcome measures were included and were rated by experts based on the available evidence within the literature supporting the strengths of their psychometric properties and practical use. Only three measures were found to be validated for use in pediatric stroke: the Pediatric Stroke Outcome Measure, the Pediatric Stroke Recurrence and Recovery Questionnaire, and the Pediatric Stroke Quality of Life Measure. However, multiple additional measures were deemed to have good psychometric properties and acceptable utility for assessing pediatric stroke outcomes. Strengths and weaknesses of commonly used measures including feasibility are highlighted to guide evidence-based and practicable outcome measure selection. Improving the coherence of outcome assessment will facilitate comparison of studies and enhance research and clinical care in children with stroke. Further work is urgently needed to close the gap and validate measures across all clinically significant domains in the pediatric stroke population.
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Affiliation(s)
- Samantha J Feldman
- Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lauren A Beslow
- Division of Neurology, Children's Hospital of Philadelphia, Departments of Neurology and Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ryan J Felling
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Laura A Malone
- Johns Hopkins University School of Medicine and the Kennedy Krieger Institute, Baltimore, Maryland
| | - Michaela Waak
- Pediatric Critical Care Research Group, Child Health Research Centre, The University of Queensland, Queensland, Australia; Pediatric Intensive Care Unit, Queensland Children's Hospital, South Brisbane, Australia
| | - Stuart Fraser
- Division of Vascular Neurology, Department of Pediatrics, University of Texas Health Science Center, Houston, Texas
| | - Nihal Bakeer
- Indiana Hemophilia and Thrombosis Center, Indianapolis, Indiana
| | - Jo Ellen M Lee
- Department of Neurology, Nationwide Children's Hospital, Columbus, Ohio
| | | | - Melissa M Howard
- Casa Colina Hospital and Centers for Healthcare, Pomona, California
| | - Beth Anne Cavanaugh
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee
| | - Robyn Westmacott
- Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lori C Jordan
- Division of Pediatric Neurology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
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Ringdahl EN, Becker ML, Hussey JE, Thaler NS, Vogel SJ, Cross C, Mayfield J, Allen DN. Executive Function Profiles in Pediatric Traumatic Brain Injury. Dev Neuropsychol 2018; 44:172-188. [PMID: 30590952 DOI: 10.1080/87565641.2018.1557190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Traumatic brain injury (TBI) results in heterogeneous patterns of neuropsychological impairment. This study investigated heterogeneity in executive function (EF) using the Comprehensive Trail Making Test (CTMT) to evaluate 121 children and adolescents with TBI and 121 matched normal controls. The TBI group performed approximately two standard deviations below controls. Cluster analyses indicated that a three-cluster solution best classified the TBI group and a four-cluster solution best classified controls. Greater impairment in EF was associated with lower intellectual, achievement, and neuropsychological test performance in the TBI group. Results suggest that EF deficits reflected in CTMT performance may be useful for classifying severity of TBI.
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Affiliation(s)
- Erik N Ringdahl
- a University of Nevada, Las Vegas , Las Vegas , Nevada , USA
| | - Megan L Becker
- a University of Nevada, Las Vegas , Las Vegas , Nevada , USA
| | - Julia E Hussey
- a University of Nevada, Las Vegas , Las Vegas , Nevada , USA
| | | | - Sally J Vogel
- a University of Nevada, Las Vegas , Las Vegas , Nevada , USA
| | - Chad Cross
- b School of Medicine and School of Community Health Sciences , University of Nevada, Las Vegas , Las Vegas , Nevada , USA
| | | | - Daniel N Allen
- a University of Nevada, Las Vegas , Las Vegas , Nevada , USA
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Abstract
The present study introduces the Verbal Associated Pairs Screen (VAPS) as a new measure for assessing performance validity in pediatric populations. This study presents initial data on psychometric properties and establishes construct validity for the VAPS in a sample of 30 adolescent healthy controls and 206 youths with traumatic brain injury (TBI: moderate/severe, N = 30; mild, N = 176). The control group's age (M = 14.93, SD = 1.8) was significantly higher than the moderate/severe TBI (M = 13.9, SD = 2.8), t(68.508) = -3.038, p = .003, and mild TBI (mTBI) groups (M = 14, SD = 2.8), t(54.147) = 2.038, p = .046. The TBI groups were administered the VAPS in accord with other established performance validity tests (PVTs) and well-established memory tests as part of routine clinical evaluations. The healthy control group was administered the VAPS only. VAPS score distributions for the control group were negatively skewed and highly kurtotic. VAPS scores from the moderate/severe TBI and control groups were indistinguishable for Trial 2 (U = 274, p < .01) and the Delay (U = 396, p = .218). In the mTBI group, convergent and divergent validity was established with other well-validated PVTs and memory tests, respectively. ROC curve analyses identified optimal cutoff scores for the VAPS Total Score, with acceptable sensitivity (55%) and excellent specificity (100%), as well as strong detectability (AUC = .829, 95% CI: 0.731 - 0.928, p < .001). Clinical applications, limitations, and directions for future research with the VAPS are discussed.
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Affiliation(s)
- Jonathan Dodd
- a Department of Psychology , St. Louis Children's Hospital , St. Louis , MO , USA.,b Department of Neurology , Washington University School of Medicine , St. Louis , MO , USA
| | - Samantha Murphy
- c Department of Psychology , University of Missouri - St. Louis , St. Louis , MO , USA
| | - Meghan Doherty
- d Department of Occupational Therapy , St. Louis Children's Hospital , St. Louis , MO , USA
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Fabri TL, Stewart ML, Stevens SA. Informing pediatric rehabilitation: Language-based neuropsychological profile following traumatic brain injury and stroke secondary to arteriovenous malformation. J Pediatr Rehabil Med 2018; 11:15-21. [PMID: 29630561 DOI: 10.3233/prm-160429] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To describe language-based neuropsychological outcomes following brain injury in two pediatric populations commonly treated in rehabilitation settings, namely severe traumatic brain injury (sTBI) and stroke secondary to arteriovenous malformation (AVM). METHODS Investigated were children between the ages of 6 and 16 who were admitted to a brain injury rehabilitation program in a pediatric rehabilitation hospital and who were diagnosed with a left-sided sTBI (n= 16; mean age = 13.2) or a left-hemispheric stroke secondary to AVM (n= 16, mean age = 10.7). Groups were compared on demographic information, as well as general cognitive and language-based neuropsychological measures, controlling for age. RESULTS Children in the AVM group presented with greater deficits, at trend levels, relative to the sTBI group on measures of working memory, verbal fluency, and an aphasia screening tool. CONCLUSIONS This study represents an initial step in understanding the language-based neuropsychological outcomes of children diagnosed with sTBI compared to those with stroke secondary to AVM, which will help inform the rehabilitation process. With this knowledge, clinicians, families, and educators will be better equipped to provide informed individual rehabilitation programs, recommendations, and education for children and adolescents with brain injuries.
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Affiliation(s)
- Tracy L Fabri
- Brain Injury Rehabilitation Team, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Mary L Stewart
- Brain Injury Rehabilitation Team, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Sara A Stevens
- Brain Injury Rehabilitation Team, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
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Johnson VM, Donders J. Correlates of verbal learning and memory after pediatric traumatic brain injury. APPLIED NEUROPSYCHOLOGY-CHILD 2017; 7:298-305. [DOI: 10.1080/21622965.2017.1330688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Velisa M. Johnson
- Department of Psychology, Mary Free Bed Rehabilitation Hospital, Grand Rapids, Michigan, USA
| | - Jacobus Donders
- Department of Psychology, Mary Free Bed Rehabilitation Hospital, Grand Rapids, Michigan, USA
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Schraegle WA, Nussbaum NL, Stefanatos AK. List-learning and verbal memory profiles in childhood epilepsy syndromes. Epilepsy Behav 2016; 62:159-65. [PMID: 27484747 DOI: 10.1016/j.yebeh.2016.07.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Revised: 07/08/2016] [Accepted: 07/11/2016] [Indexed: 11/16/2022]
Abstract
Findings of material-specific influences on memory performance in pediatric epilepsy are inconsistent and merit further investigation. This study compared 90 children (aged 6years to 16years) with childhood absence epilepsy (CAE), frontal lobe epilepsy (FLE), and temporal lobe epilepsy (TLE) to determine whether they displayed distinct list-learning and verbal memory profiles on the California Verbal Learning Test - Children's Version (CVLT-C). Group comparison identified greater risk of memory impairment in children with TLE and FLE syndromes but not for those with CAE. While children with TLE performed worst overall on Short Delay Free Recall, groups with TLE and FLE performed similarly on Long Delay Free Recall. Contrast indices were then employed to explore these differences. Children with TLE demonstrated a significantly greater retroactive interference (RI) effect compared with groups with FLE and CAE. Conversely, children with FLE demonstrated a significantly worse learning efficiency index (LEI), which compares verbal memory following repetition with initial recall of the same list, than both children with TLE and CAE. These findings indicated shallow encoding related to attentional control for children with FLE and retrieval deficits in children with TLE. Finally, our combined sample showed significantly higher rates of extreme contrast indices (i.e., 1.5 SD difference) compared with the CVLT-C standardization sample. These results underscore the high prevalence of memory dysfunction in pediatric epilepsy and offer support for distinct patterns of verbal memory performance based on childhood epilepsy syndrome.
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Affiliation(s)
- William A Schraegle
- Comprehensive Epilepsy Program, Dell Children's Medical Center of Central Texas, Austin, TX, USA; Department of Educational Psychology, The University of Texas at Austin, Austin, TX, USA.
| | - Nancy L Nussbaum
- Comprehensive Epilepsy Program, Dell Children's Medical Center of Central Texas, Austin, TX, USA; Department of Educational Psychology, The University of Texas at Austin, Austin, TX, USA
| | - Arianna K Stefanatos
- Pediatric Neuropsychology, Boston Children's Hospital/Harvard Medical School, Boston, MA, USA
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Silberg T, Ahonniska-Assa J, Levav M, Eliyahu R, Peleg-Pilowsky T, Brezner A, Vakil E. The effect of age-at-testing on verbal memory among children following severe traumatic brain injury. Child Neuropsychol 2015; 22:600-17. [DOI: 10.1080/09297049.2015.1028348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hancock LM, Bruce JM, Bruce AS, Lynch SG. Processing speed and working memory training in multiple sclerosis: A double-blind randomized controlled pilot study. J Clin Exp Neuropsychol 2015; 37:113-27. [DOI: 10.1080/13803395.2014.989818] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kurowski BG, Wade SL, Kirkwood MW, Brown TM, Stancin T, Cassedy A, Taylor HG. Association of parent ratings of executive function with global- and setting-specific behavioral impairment after adolescent traumatic brain injury. Arch Phys Med Rehabil 2012; 94:543-50. [PMID: 23131527 DOI: 10.1016/j.apmr.2012.10.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Revised: 10/28/2012] [Accepted: 10/30/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the association of primary caregiver-rated behavioral and metacognitive aspects of executive function (EF) with impaired functioning after adolescent traumatic brain injury (TBI). DESIGN Multicenter cross-sectional study. SETTING Outpatient. PARTICIPANTS Primary caregivers and children (N=132) aged 12 to 17 years who sustained a moderate or severe TBI within the past 1 to 6 months. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Primary caregiver ratings of EF, tests of memory and processing speed (PS), and a structured parent interview to assess clinical impairments in behavioral functioning were used. Logistic regression was used to examine the relation of ratings of EF with clinical ratings of impairment in global adolescent functioning and in functioning in the home, school, and community settings after controlling for sex, race, socioeconomic status, injury severity, and performance on the tests of memory and PS. RESULTS Caregiver ratings of poor EF were associated with impairment in both global behavioral functioning (odds ratio [OR]=4.73; 95% confidence interval [CI], 1.54-14.52; P<.01) and community functioning (OR=13.28; 95% CI, 1.94-90.87; P<.01). CONCLUSIONS Caregiver ratings of deficits in EF were associated with impaired behavioral functioning after adolescent TBI and were independent of performance on tests of memory and processing speed. Understanding the relation of EF with clinical impairments as manifested in different settings will help hone assessment batteries and focus treatments where they are needed most.
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Affiliation(s)
- Brad G Kurowski
- Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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Thaler NS, Allen DN, Hart JS, Boucher JR, McMurray JC, Mayfield J. Neurocognitive Correlates of the Trail Making Test for Older Children in Patients with Traumatic Brain Injury. Arch Clin Neuropsychol 2012; 27:446-52. [DOI: 10.1093/arclin/acs042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Nicholas S Thaler
- Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV 89073-5030, USA
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Lajiness-O'Neill R, Erdodi L, Bigler ED. Demographic and injury-related moderators of memory and achievement outcome in pediatric TBI. ACTA ACUST UNITED AC 2012; 18:298-308. [PMID: 22074069 DOI: 10.1080/09084282.2011.595457] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Critical factors affecting traumatic brain injury (TBI) outcome in children and adolescents are explored with an emphasis on an examination of age at injury as a predictor of memory functioning. Age at injury and other injury-related and demographic predictors (i.e., severity, time postinjury, gender, and socioeconomic status [SES]) of memory and achievement outcome were examined in 65 children and adolescents post-TBI compared to 65 age-matched noninjured controls. Although robust findings have been found for age at injury as a general predictor of outcome, age was not found to be a significant predictor of memory functioning following pediatric TBI. Structural equation modeling suggests that the most parsimonious model of post-TBI outcome contains two causally related latent variables: one defined by gender, SES, injury severity, and age at injury, and one defined by general cognitive functioning.
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McCauley SR, Wilde EA, Anderson VA, Bedell G, Beers SR, Campbell TF, Chapman SB, Ewing-Cobbs L, Gerring JP, Gioia GA, Levin HS, Michaud LJ, Prasad MR, Swaine BR, Turkstra LS, Wade SL, Yeates KO. Recommendations for the use of common outcome measures in pediatric traumatic brain injury research. J Neurotrauma 2012; 29:678-705. [PMID: 21644810 PMCID: PMC3289848 DOI: 10.1089/neu.2011.1838] [Citation(s) in RCA: 229] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This article addresses the need for age-relevant outcome measures for traumatic brain injury (TBI) research and summarizes the recommendations by the inter-agency Pediatric TBI Outcomes Workgroup. The Pediatric Workgroup's recommendations address primary clinical research objectives including characterizing course of recovery from TBI, prediction of later outcome, measurement of treatment effects, and comparison of outcomes across studies. Consistent with other Common Data Elements (CDE) Workgroups, the Pediatric TBI Outcomes Workgroup adopted the standard three-tier system in its selection of measures. In the first tier, core measures included valid, robust, and widely applicable outcome measures with proven utility in pediatric TBI from each identified domain including academics, adaptive and daily living skills, family and environment, global outcome, health-related quality of life, infant and toddler measures, language and communication, neuropsychological impairment, physical functioning, psychiatric and psychological functioning, recovery of consciousness, social role participation and social competence, social cognition, and TBI-related symptoms. In the second tier, supplemental measures were recommended for consideration in TBI research focusing on specific topics or populations. In the third tier, emerging measures included important instruments currently under development, in the process of validation, or nearing the point of published findings that have significant potential to be superior to measures in the core and supplemental lists and may eventually replace them as evidence for their utility emerges.
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Affiliation(s)
- Stephen R McCauley
- Department of Physical Medicine and Rehabilitation, Neurology, and Pediatrics, Baylor College of Medicine, and the Michael E. DeBakey Veterans Administration Medical Center, Houston, Texas 77030, USA.
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Thaler NS, Barney SJ, Reynolds CR, Mayfield J, Allen DN. Differential Sensitivity of TOMAL Subtests and Index Scores to Pediatric Traumatic Brain Injury. ACTA ACUST UNITED AC 2011; 18:168-78. [DOI: 10.1080/09084282.2011.595443] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Crocker N, Vaurio L, Riley EP, Mattson SN. Comparison of verbal learning and memory in children with heavy prenatal alcohol exposure or attention-deficit/hyperactivity disorder. Alcohol Clin Exp Res 2011; 35:1114-21. [PMID: 21410480 DOI: 10.1111/j.1530-0277.2011.01444.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Children with fetal alcohol spectrum disorders (FASD) have deficits in verbal learning and recall. However, the specificity of these deficits has not been adequately tested. In the current study, verbal learning and memory performance of children with heavy prenatal alcohol exposure was compared to children with attention-deficit/hyperactivity disorder (ADHD), a disorder commonly seen in alcohol-exposed children. METHODS Performance on the California Verbal Learning Test-Children's Version (CVLT-C) was examined in 3 groups of children (N=22/group): (i) heavy prenatal alcohol exposure and ADHD (ALC), (ii) nonexposed with ADHD (ADHD), and (iii) nonexposed typically developing (CON). Groups were matched on age, sex, race, ethnicity, handedness, and socioeconomic status (SES). RESULTS Group differences were noted on learning trials (CON >ADHD> ALC). On the delayed recall trial, CON children performed better than both clinical groups, who did not differ from each other. Children in the ALC group demonstrated poorer recognition than children in the CON and ADHD groups, who did not differ from each other. Marginally significant group differences were noted on retention of previously learned material. Post hoc analyses indicated that ADHD children showed worse retention relative to the CON group, whereas retention in the ALC children remained intact. CONCLUSIONS These data suggest that children with heavy prenatal alcohol exposure and nonexposed children with ADHD show differential patterns of deficit on the CVLT-C. Performance of alcohol-exposed children reflects inefficient encoding of verbal material, whereas performance of the ADHD group may be better characterized by a deficit in retrieval of learned material. Differences noted between clinical groups add to a growing neurobehavioral profile of FASD that may aid in differential diagnosis.
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Affiliation(s)
- Nicole Crocker
- Center for Behavioral Teratology, Department of Psychology, San Diego State University, San Diego, CA 92120, USA
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Egeland J, Johansen SN, Ueland T. Do low-effort learning strategies mediate impaired memory in ADHD? JOURNAL OF LEARNING DISABILITIES 2010; 43:430-440. [PMID: 20445203 DOI: 10.1177/0022219409355473] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
As a group, participants with attention-deficit/hyperactivity disorder (ADHD) are impaired in academic performance and learning. This may be due to a mild intellectual impairment, impaired attention, or inability to allocate sufficient effort. If the latter is the case, this should be evident in the learning strategies applied. Four indices of learning strategy, considered to measure degree of effort, were analyzed from 67 participants with ADHD and 67 age-matched normal controls between 9 and 16 years of age. The participants with ADHD were impaired with regard to semantic clustering, retroactive interference, and percentage items reported from the middle section of the list even when controlling for IQ and comorbid conduct or oppositional defiant disorders symptoms. In addition, participants with combined ADHD (ADHD-C) did not display the normal proactive interference effect. The four effort indices explained 39% and 35% of the variance in free recall among participants with inattentive ADHD (ADHD-I) and ADHD-C, respectively. IQ was still significant when the effect of strategy measures were accounted for, whereas diagnosis was no longer significant when entered into the regression analysis after the effort indices. The study shows that participants with ADHD employ less effortful learning strategies than healthy controls and that low effort to a large degree can account for diagnosis related variance in memory performance.
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Affiliation(s)
- Jens Egeland
- Department of Research, Vestfold Mental Health Care Trust, Tønsberg, Norway.
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Lajiness-O'Neill R, Erdodi L, Bigler ED. Memory and learning in pediatric traumatic brain injury: a review and examination of moderators of outcome. ACTA ACUST UNITED AC 2010; 17:83-92. [PMID: 20467947 DOI: 10.1080/09084281003708837] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This article reviews empirically supported assessment methods to examine impairments in memory and learning following pediatric traumatic brain injury (TBI). Critical factors affecting outcome are explored with an emphasis on an examination of age at injury. The article closes with discussion of current evidence-based interventions for deficits in memory and learning following pediatric TBI.
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Affiliation(s)
- Renee Lajiness-O'Neill
- Department of Psychology, Eastern Michigan University, 537 F Mark Jefferson, Ypsilanti, MI 48197, USA.
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Static and Dynamic Visuomotor Task Performance in Children With Acquired Brain Injury. J Head Trauma Rehabil 2009; 24:363-73. [DOI: 10.1097/htr.0b013e3181af0810] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Prigatano GP, Gray JA, Gale SD. Individual case analysis of processing speed difficulties in children with and without traumatic brain injury. Clin Neuropsychol 2008; 22:603-19. [PMID: 17853123 DOI: 10.1080/13854040701440501] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Two studies were conducted to determine the frequency of processing speed difficulties relative to estimates of other problem-solving abilities in children with and without traumatic brain injury (TBI). The two samples consisted of 213 normally functioning school-age children and 65 TBI children and 19 trauma controls. All children were administered the WISC-III/IV Vocabulary, Block Design, and Coding subtests. The frequency of children in each sample having a Coding subtest score of 3 or 4 scale points below the Vocabulary or Block Design score (whichever one was lower) was calculated. Using a 3-point scale difference, the presence of processing speed deficits relative to other cognitive abilities in the school sample was low (5.2%), and was equivalent to that demonstrated by trauma controls (5.3%). However, in the TBI sample, 18 out of 65 TBI patients (27.7%) showed this same pattern. Using a 4-point discrepancy scale, 3.3% of normal children and 16.9% of TBI children showed this pattern. The frequency of this pattern increased with severity of TBI, using two different but related classification systems. These preliminary findings require cross validation in a larger sample before definite conclusions can be reached.
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Affiliation(s)
- George P Prigatano
- Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
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Parental Perspectives on Recovery and Social Reintegration After Pediatric Traumatic Brain Injury. J Head Trauma Rehabil 2008; 23:378-87. [DOI: 10.1097/01.htr.0000341433.67251.01] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Levin HS, Hanten G, Roberson G, Li X, Ewing-Cobbs L, Dennis M, Chapman S, Max JE, Hunter J, Schachar R, Luerssen TG, Swank P. Prediction of cognitive sequelae based on abnormal computed tomography findings in children following mild traumatic brain injury. J Neurosurg Pediatr 2008; 1:461-70. [PMID: 18518697 DOI: 10.3171/ped/2008/1/6/461] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT The aim of this study was to determine whether the presence of intracranial pathophysiology on computed tomography (CT) scans obtained within 24 hours of mild traumatic brain injury (MTBI) in children adversely affects neuropsychological outcome during the 1st year postinjury. METHODS A prospective longitudinal design was used to examine the neuropsychological outcomes in children (ages 5-15 years) who had been treated for MTBI, which was defined as a loss of consciousness for up to 30 minutes and a lowest Glasgow Coma Scale (GCS) score of 13-15. Exclusion criteria included any preinjury neurological disorder. Outcome assessments were performed within 2 weeks and at 3, 6, and 12 months postinjury. Outcomes were compared between patients with MTBI whose postinjury CT scans revealed complications of brain pathophysiology (32 patients, CMTBI group) and those with MTBI but without complications (48 patients, MTBI group). RESULTS Significant interactions confirmed that the pattern of recovery over 12 months after injury differed depending on the intracranial pathology, presence and severity of injuries to body regions other than the head, preinjury attention-deficit hyperactivity disorder (ADHD), and socioeconomic status. Children in the CMTBI group had significantly poorer episodic memory, slower cognitive processing, diminished recovery in managing cognitive interference, and poorer performance in calculating and reading than patients in the MTBI group. Among the patients with mild or no extracranial injury, visuomotor speed was slower in those in the CMTBI group; and among patients without preinjury ADHD, working memory was worse in those in the CMTBI group. CONCLUSIONS Neuropsychological recovery during the 1st year following MTBI is related to the presence of radiographically detectable intracranial pathology. Children with intracranial pathology on acute CT performed more poorly in several cognitive domains when compared with patients whose CT findings were normal or limited to a linear skull fracture. Depending on the presence of preinjury ADHD and concomitant extracranial injury, working memory and visuomotor speed were also diminished in patients whose CT findings revealed complications following MTBI. Computed tomography within 24 hours postinjury appears to be useful for identifying children with an elevated risk for residual neuropsychological changes.
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Affiliation(s)
- Harvey S Levin
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA.
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Prigatano GP, Gupta S, Gale S. Fuld Object Memory Evaluation Adapted for School-Age Children. Dev Neuropsychol 2007; 32:757-68. [DOI: 10.1080/87565640701539469] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Salorio CF, Slomine BS, Grados MA, Vasa RA, Christensen JR, Gerring JP. Neuroanatomic correlates of CVLT-C performance following pediatric traumatic brain injury. J Int Neuropsychol Soc 2005; 11:686-96. [PMID: 16248904 DOI: 10.1017/s1355617705050885] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2004] [Revised: 05/12/2005] [Accepted: 05/19/2005] [Indexed: 11/06/2022]
Abstract
Traumatic brain injury (TBI) frequently results in memory problems, and the degree of memory impairment is related to injury severity and is commonly associated with lesions in frontal and temporal brain areas. This study examined the relationship among injury severity, brain lesions, and memory in children with moderate to severe TBI using Donders' (1999) 5-factor model of performance on the California Verbal Learning Test-Children's Version (CVLT-C). Seventy-six children underwent magnetic resonance imaging (MRI) scans 3 months post-TBI and testing 1 year post-TBI. Results showed injury severity (Glasgow Coma Scale) was not predictive of performance on 4 of the 5 factors. Volume of frontal and/or temporal brain lesions was significantly predictive of performance on 3 of the 5 factors. Unexpectedly, lesion volume outside these areas (extra-frontotemporal) was predictive of performance on all 5 factors. In contrast, Verbal IQ at 1 year was most strongly associated with preinjury factors (socioeconomic status and special education involvement), although extra-frontotemporal lesions also contributed to the variability in this measure. Results suggest that in children with moderate to severe TBI, extra-frontal/temporal lesions are predictive of memory outcome 1 year postinjury above and beyond initial severity or frontal/temporal contusions. This finding may relate to widespread diffuse axonal injury, which potentially disconnects brain circuits mediating memory following moderate to severe TBI.
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Affiliation(s)
- Cynthia F Salorio
- Department of Pediatric Rehabilitation, Kennedy Krieger Institute, Baltimore, Maryland 21205, USA.
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Mottram L, Donders J. Construct validity of the California Verbal Learning Test--Children's Version (CVLT-C) after pediatric traumatic brain injury. Psychol Assess 2005; 17:212-7. [PMID: 16029108 DOI: 10.1037/1040-3590.17.2.212] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this study was to determine the latent structure of the California Verbal Learning Test--Children's Version (CVLT-C; D. Delis, J. Kramer, E. Kaplan, & B. Ober, 1994) in a sample of 175 children with traumatic brain injury (TBI). Maximum-likelihood confirmatory factor analyses were performed to test 6 competing hypothetical models for fit and parsimony. A 4-factor model consisting of Attention Span, Learning Efficiency, Delayed Recall, and Inaccurate Recall provided the best fit to the data. The results support the construct validity of the CVLT-C in children with TBI and suggest that a multifactorial interpretation of quantitative indexes from this instrument is appropriate for clinical practice.
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Affiliation(s)
- Lisa Mottram
- Psychology Service, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI 49503, USA
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