Assessment of executive functions in children and adolescents with acquired brain injury (ABI) using a novel complex multi-tasking computerised task: The Jansari assessment of Executive Functions for Children (JEF-C©).

Objectives: The Jansari assessment of Executive Functions for Children (JEF-C©) is a new non-immersive computerised assessment of executive functions. The objectives of the study were to test the feasibility and validity of JEF-C© in children and adolescents with acquired brain injury (ABI). Methods: Twenty-nine patients with ABI aged 10-18 years and 30 age-and gender-matched controls were tested. Participants performed JEF-C©, Wechsler Abbreviated Scale of Intelligence (WASI) and the Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C), while parents completed the Behaviour Rating Inventory of Executive Function (BRIEF) questionnaire. Results: The JEF-C© task proved feasible in patients with ABI. The internal consistency was medium (Cronbach's alpha = 0.62 and significant intercorrelations between individual JEF-C© constructs). Patients performed significantly worse than controls on most of the JEF-C© subscales and total score, with 41.4% of participants with ABI classified as having severe executive dysfunction. No significant correlations were found between JEF-C© total score, the BRIEF indices, and the BADS-C. Significant correlations were found between JEF-C© and demographic characteristics of the sample and intellectual ability, but not with severity/medical variables. Conclusion: JEF-C© is a playful complex task that appears to be a sensitive and ecologically valid assessment tool, especially for relatively high-functioning individuals.

Long-term motor, functional, and academic outcome following childhood ischemic and hemorrhagic stroke: A large rehabilitation center-based retrospective study.

OBJECTIVE: To study the long-term outcomes following childhood ischemic and hemorrhagic stroke. METHODS: This was a retrospective study, looking at children consecutively admitted to a rehabilitation department following childhood stroke. We collected demographic, medical, and severity data, motor deficit, cognitive assessment, and long-term academic outcome. RESULTS: One hundred and twenty-eight children were included, following arterial ischemic (AIS; n = 46) or hemorrhagic (HS; n = 82) stroke. At discharge, motor deficit was still present in 70% of children (versus 89% immediately after stroke). HS predicted significantly better motor and functional outcomes than AIS. After a median follow-up of 43 months, 40% received special education. The receipt of special education was predicted by persistent motor deficit, but when full-scale IQ was taken into account, IQ was the only significant predictor of special education. CONCLUSIONS: Childhood stroke leads to severe and long lasting motor, functional, cognitive, and academic impairments, in a population of children admitted in a rehabilitation department.

Metamemory following childhood brain injury: A consequence of executive impairment.

In this study, we investigated the influence of children's level of executive functioning on two types of metamemory knowledge following a traumatic brain injury (TBI). For this purpose, 22 children (aged 7 to 14 years) who had sustained a moderate to severe TBI and 44 typically developing children were recruited. The children with TBI were divided into two groups according to the severity of their executive impairment. Injury severity was determined by the Glasgow Coma Scale (GCS) score on admission or by the duration of unconsciousness. All children were then tested on both their knowledge of general memory functioning and their level of memory self-awareness, respectively assessed using the total number of correct responses on an adapted version of a metamemory interview and a self-other discrepancy score on a questionnaire evaluating everyday memory abilities. Data analyses revealed that participants with TBI who suffered impaired executive functions demonstrated less general metamemory knowledge, and underestimated the frequency of their memory problems, compared with children with TBI who had preserved executive functions and with control participants. Considering the well-established effect of metamemory knowledge on people's spontaneous implementation of strategies, the interest and the importance of these findings on both theoretical and clinical grounds are discussed.

Describing the attention profile of children and adolescents with acquired brain injury using the Virtual Classroom.

OBJECTIVES: The objectives of the study were: (1) to describe the attention deficits profile of children with significant acquired brain injury (ABI) in comparison to matched controls, using the virtual classroom (VC); (2) to assess the utility of the VC in detecting attention deficits in children with ABI, as compared to classical neuropsychological tests and questionnaire-based assessment of attention; and (3) to determine how performance in the VC is affected by demographic and injury severity variables. METHODS: Forty-one children with ABI and 35 age- and gender-matched controls, aged 8-16, were assessed with the VC. The results of the VC were compared to sub-tests of the Test of Everyday Attention for Children (TEA-Ch), the Conners' Parent Rating Scales-Revised: Short (CPRS-R:S) questionnaire and analysed according to demographic and injury severity variables. RESULTS: Significant differences were found between the groups regarding the number of targets correctly identified in the VC. Significant inter-correlations were obtained between the VC variables. Significant correlations were found between the VC variables, the sub-tests of TEA-Ch and the CPRS-R:S and the demographic characteristics of the sample. CONCLUSION: The VC appears to be a sensitive and ecologically valid assessment tool for use in the diagnosis of attention deficits among children with ABI.