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Lindsay S, Patel S, Ragunathan S, Fuentes K. Ableism among children and youth with acquired brain injury and their caregivers: a systematic review. Brain Inj 2023:1-12. [PMID: 36856419 DOI: 10.1080/02699052.2023.2184869] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
PURPOSE Children and youth with acquired brain injury (ABI) experience persistent discrimination and ableism. The purpose of this systematic review was to understand the experiences and impact of ableism among children and youth with ABI. METHOD Six international databases were systematically searched for articles from 2002-2022. Studies were screened independently by four researchers who performed the data extraction. Study quality was appraised using the Standard quality assessment criteria for evaluating primary research. RESULTS Of the 2085 studies identified in the search, 15 met the inclusion criteria, which involved 1442 children and youth with brain injuries or caregivers representing them. Studies in the review showed the following key trends: (1) incidence of ableism among children and youth with ABI; (2) experiences of ableism at the individual and institutional levels, (3) impact of ableism (i.e., mental health, social relationships, quality of life) and (4) coping strategies (i.e., resources, supports). CONCLUSIONS Our findings reveal the alarming incidence of ableism among youth with ABI. Therefore, there is a critical need for more research to explore youth's lived experiences of ableism, especially from their perspectives along with the co-development of solutions to help enhance their social inclusion and well-being.
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Affiliation(s)
- Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Stuti Patel
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Psychology, University of Toronto Mississauga, Mississauga, Canada
| | - Sharmigaa Ragunathan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Kristina Fuentes
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
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Urban–Rural Distinction or Economic Segmentation: A Study on Fear and Inferiority in Poor Children’s Peer Relationships. Healthcare (Basel) 2022; 10:healthcare10102057. [PMID: 36292501 PMCID: PMC9601905 DOI: 10.3390/healthcare10102057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/30/2022] Open
Abstract
Peer relationships play an important role in the growth of children. This study offers insights about feelings of fear and inferiority in children’s peer relationships. Based on a national survey, the 2018 Construction for Social Policy Support System for Urban and Rural Poor Families in China, initiated by the Ministry of Civil Affairs, and using multiple regression models and a structural equation model, this study discusses whether and how having a rural household registration or being from a poor (dibao) family has an isolation effect on fear and inferiority in children’s peer relationships. The research findings indicate that children with a rural household registration or those from a dibao family are at a disadvantage in peer interactions. Moreover, rural resident identity has an indirect effect on children’s fear of peers and inferiority, mainly through psychological resilience, anxiety and depression, and mobile phone dependence. Being from a dibao family directly influences children’s fear and inferiority in their peer relationships; it also indirectly influences fear of peers and inferiority through psychological resilience. This study suggests that more attention should be paid to fear of peers and inferiority in rural children or children from a dibao family.
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Rogers A, McKinlay A. The long-term effects of childhood traumatic brain injury on adulthood relationship quality. Brain Inj 2019; 33:649-656. [PMID: 30664366 DOI: 10.1080/02699052.2019.1567936] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PRIMARY OBJECTIVE To investigated the long-term effect of childhood Traumatic Brain Injury (TBI) on adulthood Relationship Quality (RQ), examining injury severity, age of injury, and markers of prefrontal cortex (PFC) functioning, apathy, disinhibition, and executive dysfunction. RESEARCH DESIGN Longitudinal, between-subjects, cross-sectional design using retrospective and current data. METHODS AND PROCEDURES Participants (N = 169; 61 mild TBI (mTBI); 65 moderate to severe TBI (MSTBI); 43 orthopaedic injury (OI); Injury age: 1-17 years; Testing age: 18-31 years) completed a structured interview regarding their injury, demographic characteristics and RQ, the National Adults Reading Test, and Frontal Systems Behaviour Scale. Data were analyzed using IBM SPSS 25. MAIN OUTCOMES AND RESULTS Adults who had experienced childhood TBI had significantly poorer RQ than adults who had experienced childhood OI. Severity of TBI did not impact adulthood RQ. Earlier age of injury predicted reduced adulthood RQ in the MSTBI group. Greater PFC dysfunction predicted poorer RQ in adults with a history of childhood TBI. While elevated levels of apathy, disinhibition, and executive dysfunction were associated with poorer RQ, no individual marker had predictive value. CONCLUSION Experiencing a childhood TBI can have a long-term negative influence on adulthood RQ. Such RQ deficits can underpin reduced life satisfaction and increased health issues.
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Affiliation(s)
- Alana Rogers
- a Melbourne School of Psychological Sciences , The University of Melbourne , Melbourne , Australia.,b School of Psychological Sciences , University of Melbourne , Melbourne , Australia
| | - Audrey McKinlay
- b School of Psychological Sciences , University of Melbourne , Melbourne , Australia.,c Department of Psychology , University of Canterbury , Melbourne , Australia
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Pastore V, Galbiati S, Recla M, Colombo K, Beretta E, Strazzer S. Psychological and behavioural difficulties following severe TBI in adolescence: a comparison with a sample of peers with brain lesions of other origin and with a control group. Brain Inj 2018; 32:1011-1020. [PMID: 29738269 DOI: 10.1080/02699052.2018.1469041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To describe behavioural and adjustment problems in a group of 57 adolescents with severe traumatic brain injury (TBI) and compare them with a clinical group of peers with brain lesions of other origin (N = 33) and a control group of healthy adolescents (N = 48). METHODS All subjects received an age-appropriate assessment, including the child behaviour checklist (CBCL) 4/18, the strengths and difficulties questionnaire (SDQ) and the vineland adaptive behaviour scales (VABS). RESULTS Compared with healthy peers, adolescents with TBI presented with more marked behavioural problems on most CBCL scales (Internalization and Externalization domains were both affected) and on the SDQ Hyperactivity and Peer problems scales. They also showed a more impaired functioning in most VABS domains. Compared with adolescents with brain lesions of other aetiology, patients with TBI showed more conduct problems on the SDQ scale, but no significant differences were found on the CBCL scales. Regarding the VABS, patients with other lesions presented with the worst outcome in the Motor and Daily Living Skills domains. CONCLUSIONS Adolescents with TBI are exposed at a very high risk to develop behavioural and psychological disturbances with the potential to severely affect their social re-entry. Further knowledge is needed to plan early and well-timed interventions.
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Affiliation(s)
- Valentina Pastore
- a Neurophysiatric Department , 'Eugenio Medea' Scientific Institute , Lecco , Bosisio Parini , Italy
| | - Susanna Galbiati
- a Neurophysiatric Department , 'Eugenio Medea' Scientific Institute , Lecco , Bosisio Parini , Italy
| | - Monica Recla
- a Neurophysiatric Department , 'Eugenio Medea' Scientific Institute , Lecco , Bosisio Parini , Italy
| | - Katia Colombo
- a Neurophysiatric Department , 'Eugenio Medea' Scientific Institute , Lecco , Bosisio Parini , Italy
| | - Elena Beretta
- a Neurophysiatric Department , 'Eugenio Medea' Scientific Institute , Lecco , Bosisio Parini , Italy
| | - Sandra Strazzer
- a Neurophysiatric Department , 'Eugenio Medea' Scientific Institute , Lecco , Bosisio Parini , Italy
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Ciccia AH, Beekman L, Ditmars E. A clinically focused systematic review of social communication in pediatric TBI. NeuroRehabilitation 2018; 42:331-344. [DOI: 10.3233/nre-172384] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Angela Hein Ciccia
- Department of Psychological Sciences, Communication Sciences Program, Case Western Reserve University, Cleveland, OH, USA
| | - Leah Beekman
- Department of Psychological Sciences, Communication Sciences Program, Case Western Reserve University, Cleveland, OH, USA
| | - Emily Ditmars
- Department of Psychological Sciences, Communication Sciences Program, Case Western Reserve University, Cleveland, OH, USA
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Associations between a history of traumatic brain injuries and conduct disorder during youth in a population sample of Canadian adults. Psychiatry Res 2017; 258:184-188. [PMID: 28867408 DOI: 10.1016/j.psychres.2017.08.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 07/12/2017] [Accepted: 08/09/2017] [Indexed: 11/23/2022]
Abstract
This study describes the association between history of traumatic brain injury (TBI) and childhood symptoms of conduct disorder (CD). Data were based on telephone interviews with 6048 respondents derived from the 2011-2013 cycles of a representative cross-sectional survey of adults aged 18+ years in Ontario, Canada. TBI was defined as loss of consciousness for at least 5min or overnight hospitalization due to injury symptoms. Symptoms of CD before 15 years of age were assessed using five items based on the DSM-IV. Adults who reported a history of TBI reported odds 3 times higher for possible CD before 15 years of age. Odds remained significant even when age, sex, marital status, income, and education were statistically controlled. The nature of this data precludes determining if TBI occurred before or following CD symptoms. Nonetheless, the co-occurrence of a history of TBI with symptoms of CD supports the recommendation that practitioners be vigilant in assessing the history of both CD and TBI when diagnosing and treating one of these conditions. These findings do not exclude the possibility that TBI during childhood or youth may be interfering with brain development and could co-occur with conduct behaviors in both the short and long term.
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Tonks J, Williams WH, Slater A, Frampton I. Is damage to the pre-frontal cortex dormant until adolescence, or difficult to detect? Looking for keys that unlock executive functions in children in the wrong place. Med Hypotheses 2017; 108:24-30. [PMID: 29055394 DOI: 10.1016/j.mehy.2017.07.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 07/19/2017] [Accepted: 07/24/2017] [Indexed: 01/09/2023]
Abstract
A range of functions can be negatively affected by pre-frontal cortex (PFC) injury, but observed behavioural and social changes are commonly linked to post-injury changes in executive function. Executive functioning is a complex neuropsychological construct which is further complicated by neuro-developmental processes when applied to children. There is a substantial and continuing evidence base that supports the view that early childhood pre-frontal cortex (PFC) injury results in hidden, dormant, or sleeping effects. In contrast, recent and rapidly accruing contemporary studies provide preliminary evidence that challenge the view that PFC associated impairments are completely 'hidden'. Studies that examine the various functions of the PFC and differentiate these to provide preliminary evidence to indicate earlier EF development than that which develops upon reaching adolescence, are reviewed here, together with research that identifies early predictors of later EF impairments. It remains that studies of PFC function and/or structural brain-changes are substantially complicated by issues related to definition regarding functions of the PFC, measurement of EF and other PFC-related functions that may be better understood as meta-processes. These issues are discussed in the concluding sections of this paper.
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Affiliation(s)
- James Tonks
- School of Psychology, University of Lincoln, Lincoln, UK; University of Exeter Medical School, Exeter, UK.
| | | | - Alan Slater
- School of Psychology, University of Exeter, Exeter, UK
| | - Ian Frampton
- School of Psychology, University of Lincoln, Lincoln, UK; School of Psychology, University of Exeter, Exeter, UK
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Abstract
BACKGROUND Prior studies suggest a link between head injuries and substance use but do not routinely capture mechanisms connecting the two. OBJECTIVES The goal of the study was to explore whether past head injuries predicted current substance use among young adults, taking factors such as stress, self-esteem, temper, and risk-taking into consideration. METHODS Data were drawn from a web-based survey conducted in 2014 and 2015 at a public university in the United States (n = 897). Questions were asked about history of head injuries as well as past 12-month binge drinking, marijuana use, and prescription drug misuse. To evaluate the association between head injury and substance use, two logistic regression models were performed for each substance. Head injury was first regressed on the outcome, then related risk factors were entered into the models to determine whether they explained any association between injury and outcome. RESULTS A history of multiple head injuries was associated with increased odds of bingeing, marijuana, and prescription drug use. Prior delinquency and risk-taking accounted for the associations with bingeing and marijuana use. Taking all variables into consideration, multiple head injuries were associated with greater odds for prescription drug misuse. CONCLUSIONS Results suggest the need to give consideration to a range of concomitant variables when considering behavioral outcomes associated with head injury. Head injuries may be a marker of a constellation of risk-taking behaviors that contributes to substance use. For those with multiple injuries, misuse of prescription drugs may be an attempt to cope with lingering side effects.
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Affiliation(s)
- Lisa A Kort-Butler
- a Department of Sociology , University of Nebraska-Lincoln , Lincoln , Nebraska , USA
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Levy NK, Milgram N. Cognitive contributions to theory of mind ability in children with a traumatic head injury. Child Neuropsychol 2014; 22:177-96. [DOI: 10.1080/09297049.2014.985642] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Age at injury, emotional problems and executive functioning in understanding disrupted social relationships following childhood acquired brain injury. ACTA ACUST UNITED AC 2014. [DOI: 10.1108/scn-08-2013-0030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– Clinically significant childhood acquired brain injury (ABI) is associated with increased risk of emotional and behavioural dysfunction and peer relationship problems. The purpose of this paper is to determine how emotional and peer related problems for children with ABI compare with those of children referred to mental health services, and to identify clinical predictors of peer relationship problems in a heterogeneous sample typical of a specialist community rehabilitation setting.
Design/methodology/approach
– Participants were 51 children with clinically significant ABI (32 traumatic brain injury; 29 male) referred for outpatient neuropsychological rehabilitation. Emotional, behavioural and social outcomes were measured using the Strengths and Difficulties Questionnaire (SDQ), and executive functioning was measured with the Behaviour Rating Inventory of Executive Functions. Correlational analyses were used to explore variables associated with peer relationships. A subgroup (n=27) of children with ABI were compared to an age and sex matched mental health group to determine differences on SDQ subscales.
Findings
– The SDQ profiles of children with clinically significant ABI did not significantly differ from matched children referred to mental health services. Time since injury, peer relationship problems, metacognitive, and behavioural problems correlated with age at injury. These variables and SDQ emotional problems correlated with peer relationship problems. Linear multiple regression analysis indicated that only metacognitive skills remained a significant predictor of peer relationship problems, and metacognitive skills were found to significantly mediate between age at injury and peer relationship problems.
Research limitations/implications
– The study confirms the significant effect of childhood ABI on relationships with peers and mental health, those injured at a younger age faring worst. Within the methodological constraints of this study, the results tentatively suggest that age of injury influences later peer relationships via the mediating role of poor metacognitive skills within a heterogeneous clinical sample.
Originality/value
– This is the first study to examine the roles of emotional, behavioural and executive variables on the effect of age at injury on peer relationship problems in a sample with a wide range of ages and ages of injury.
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Tonks J, Yates PJ, Williams HW, Frampton I, Slater A. Measurement Issues: Neuropsychological assessment with children and adolescents; unlocking the mysticism, methods and measures with the help of Tom Swift. Child Adolesc Ment Health 2014; 19:151-158. [PMID: 32878380 DOI: 10.1111/camh.12043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/01/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND SCOPE In this article, we provide a brief overview of the principles that guide paediatric neuropsychological assessment, the methods used and some examples of the measures available. FINDINGS We explore intellectual, adaptive and social functioning from a neuropsychological perspective and describe suitable measures for use in paediatric neuropsychological assessment in each domain. CONCLUSIONS We provide an example of assessment and interpretation using a fictional character (Tom Swift) to demonstrate that neuropsychological assessment is important in understanding the everyday questions that arise in children's services around risk, needs, level of understanding and capacity to engage with services.
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Affiliation(s)
- James Tonks
- College of Life and Environmental Sciences, University of Exeter, Washington Singer Laboratories, Perry Rd, Exeter, EX4 4QG, UK
| | - Phil J Yates
- College of Life and Environmental Sciences, University of Exeter, Washington Singer Laboratories, Perry Rd, Exeter, EX4 4QG, UK
| | - Huw W Williams
- College of Life and Environmental Sciences, University of Exeter, Washington Singer Laboratories, Perry Rd, Exeter, EX4 4QG, UK
| | - Ian Frampton
- College of Life and Environmental Sciences, University of Exeter, Washington Singer Laboratories, Perry Rd, Exeter, EX4 4QG, UK
| | - Alan Slater
- College of Life and Environmental Sciences, University of Exeter, Washington Singer Laboratories, Perry Rd, Exeter, EX4 4QG, UK
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Ilie G, Mann RE, Boak A, Adlaf EM, Hamilton H, Asbridge M, Rehm J, Cusimano MD. Suicidality, bullying and other conduct and mental health correlates of traumatic brain injury in adolescents. PLoS One 2014; 9:e94936. [PMID: 24736613 PMCID: PMC3988100 DOI: 10.1371/journal.pone.0094936] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 03/20/2014] [Indexed: 11/18/2022] Open
Abstract
Objective Our knowledge on the adverse correlates of traumatic brain injuries (TBI), including non-hospitalized cases, among adolescents is limited to case studies. We report lifetime TBI and adverse mental health and conduct behaviours associated with TBI among adolescents from a population-based sample in Ontario. Method and Findings Data were derived from 4,685 surveys administered to adolescents in grades 7 through 12 as part of the 2011 population-based cross-sectional Ontario Student Drug Use and Health Survey (OSDUHS). Lifetime TBI was defined as head injury that resulted in being unconscious for at least 5 minutes or being retained in the hospital for at least one night, and was reported by 19.5% (95%CI:17.3,21.9) of students. When holding constant sex, grade, and complex sample design, students with TBI had significantly greater odds of reporting elevated psychological distress (AOR = 1.52), attempting suicide (AOR = 3.39), seeking counselling through a crisis help-line (AOR = 2.10), and being prescribed medication for anxiety, depression, or both (AOR = 2.45). Moreover, students with TBI had higher odds of being victimized through bullying at school (AOR = 1.70), being cyber-bullied (AOR = 2.05), and being threatened with a weapon at school (AOR = 2.90), compared with students who did not report TBI. Students with TBI also had higher odds of victimizing others and engaging in numerous violent as well as nonviolent conduct behaviours. Conclusions Significant associations between TBI and adverse internalizing and externalizing behaviours were found in this large population-based study of adolescents. Those who reported lifetime TBI were at a high risk for experiencing mental and physical health harms in the past year than peers who never had a head injury. Primary physicians should be vigilant and screen for potential mental heath and behavioural harms in adolescent patients with TBI. Efforts to prevent TBI during adolescence and intervene at an early stage may reduce injuries and comorbid problems in this age group.
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Affiliation(s)
- Gabriela Ilie
- Division of Neurosurgery and Injury Prevention Research Office, St. Michael's Hospital, Toronto, Ontario, Canada
- * E-mail:
| | - Robert E. Mann
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Community Health and Epidemiology and Department of Emergency Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Angela Boak
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Edward M. Adlaf
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Hayley Hamilton
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mark Asbridge
- Department of Community Health and Epidemiology and Department of Emergency Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jürgen Rehm
- Social and Epidemiological Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Michael D. Cusimano
- Division of Neurosurgery and Injury Prevention Research Office, St. Michael's Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Tonks J, Yates P, Frampton I, Williams WH, Harris D, Slater A. Resilience and the mediating effects of executive dysfunction after childhood brain injury: A comparison between children aged 9–15 years with brain injury and non-injured controls. Brain Inj 2011; 25:870-81. [PMID: 21631188 DOI: 10.3109/02699052.2011.581641] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- James Tonks
- School of Psychology, University of Exeter, Exeter, Devon, UK.
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