NeuroRehabilitation - Volume 23, issue 6

Authors: Kennedy, Mary R.T.

Article Type: Introduction

DOI: 10.3233/NRE-2008-23601

Citation: NeuroRehabilitation, vol. 23, no. 6, pp. 455-456, 2008

Authors: Marcantuono, Joseph T. | Prigatano, George P.

Article Type: Research Article

Abstract: In the field of pediatric neurorehabilitation, there is a dearth of well-defined models of care for children with brain injuries and research to support them. Literature reviews of both adult and pediatric studies suggest that programs involving a comprehensive and holistic approach to care may be particularly effective in addressing the issues faced by individuals recovering from acquired brain injury. The primary purpose of this paper is to propose a model of holistic neurorehabilitation for children with an acquired brain injury, and to describe its theoretical bases. The paper describes such a program developed at Children's Specialized Hospital in New …Jersey, USA, and presents a brief synopsis of the program's philosophy, components, goals, and therapeutic interventions. In addition, the paper discusses the type of data necessary to demonstrate the clinical utility and cost-effectiveness of such a program, and calls for future research to examine this. Show more

Keywords: Pediatric, neurorehabilitation, cognitive, rehabilitation, brain injury, TBI, treatment model, comprehensive, holistic, day treatment, therapeutic milieu

DOI: 10.3233/NRE-2008-23602

Citation: NeuroRehabilitation, vol. 23, no. 6, pp. 457-466, 2008

Authors: Cook, Lori G. | Chapman, Sandra B. | Levin, Harvey S.

Article Type: Research Article

Abstract: Research suggests that the occurrence of a traumatic brain injury (TBI) in childhood may disrupt self-regulation abilities, putting children at risk for difficulty on everyday tasks requiring self-regulation throughout their development. In the current exploratory study, a novel age-appropriate task assessed the ability to perform three familiar tasks using real objects while adhering to specific rules. Performance of children (ages 8–16) with severe TBI (n = 11) on the naturalistic task was compared to that of typically developing children (n = 21), including measures of the amount/types of errors and number of broken rules. The children with TBI …exhibited significantly increased use of distractor objects in place of target objects as compared to the non-injured children. Additionally, children with TBI demonstrated trends of increased breaking of rules during the task and failure to include necessary steps. The preliminary results support the theory that children with severe TBI possess inefficient supervisory processes of self-regulation, corresponding to a decreased ability to carry out goal-based top-down processing. They may instead exhibit a bias towards a bottom-up approach, depending primarily on environmental cues such as the objects present to guide their actions, thus impeding self-regulation abilities. Show more

Keywords: Brain injury, children, executive function, self-regulation, supervisory attention, top-down processing, naturalistic action, script

DOI: 10.3233/NRE-2008-23603

Citation: NeuroRehabilitation, vol. 23, no. 6, pp. 467-475, 2008

Authors: Glang, Ann | Todis, Bonnie | Thomas, Catherine W. | Hood, Donald | Bedell, Gary | Cockrell, Janice

Article Type: Research Article

Abstract: Long-term follow-up studies of children conducted during the K-12 school years suggest that problems associated with TBI tend to persist or worsen as children progress through school. A critical issue in service delivery for students with TBI is the significant discrepancy between the incidence of TBI and the identification of children with TBI for special education services. The purpose of this study was to examine factors that influence identification and service practices for students with TBI. Parents of 56 youth with TBI completed a questionnaire and interview about the hospital-school transition and educational services provided within the first year of …school re-entry. A subsample participated in a concurrent qualitative study. Results document that 25% of the sample were identified for formal services (via individual education plan or 504 plan) while over 41% received informal supports (e.g., schedule change, extra time on tests). Results from chi-square and logistic regression analyses suggest that injury severity and hospital-school transition services (e.g., written or verbal communication between hospital and school) were related to the provision of formal special education or 504 services. A critical factor contributing to the identification of students with TBI for special education is the link between hospital and school. Show more

Keywords: Special education, traumatic brain injury

DOI: 10.3233/NRE-2008-23604

Citation: NeuroRehabilitation, vol. 23, no. 6, pp. 477-486, 2008

Authors: DePompei, Roberta | Gillette, Yvonne | Goetz, Elaine | Xenopoulos-Oddsson, Annette | Bryen, Diane | Dowds, Murdo

Article Type: Research Article

Abstract: It is often recommended that individuals with memory and organizational problems after a traumatic brain injury (TBI) use some type of memory device such as a paper calendar. Recently the use of electronic devices has been suggested. This article outlines data obtained from in vivo trials using personal data assistants (PDAs) and follow up in depth studies with PDAs and smartphones. These trials were conduced with individuals who had memory and organizational problems as a result of cognitive disorders of traumatic brain injury (TBI) or intellectual disability (ID) Results indicate that the use of electronic devices can enhance independent behavior. …Factors influencing success include: student motivation, audible beep of the device; support for programming and troubleshooting, alterations of functions; and selection of features to motivate. Based on the result of the studies, an intervention plan for use of PDAs was developed for use by clinicians. Show more

Keywords: Pediatric traumatic brain injury, PDAs, smartphones, memory and organizational, intervention plan

DOI: 10.3233/NRE-2008-23605

Citation: NeuroRehabilitation, vol. 23, no. 6, pp. 487-499, 2008

Authors: Turkstra, Lyn S. | Williams, W. Huw | Tonks, James | Frampton, Ian

Article Type: Research Article

Abstract: In everyday adolescent communication, the ability to empathise with the mental state of others, recognise or infer intentions, or make judgements about emotional state, is a non-conscious but vital prerequisite of relating. Execution of these skills in social interactions supports both the exchange of social knowledge and also the development and maintenance of personal relationships. Thus, adolescents with impairments in these skills are at risk for a variety of negative outcomes. In this paper, we present data to illustrate that adolescents with traumatic brain injury (TBI) are likely to have impairments in processes such as emotion recognition and mental state …attribution, and that these might not be identified on standardised tests. This is considered from the perspective of clinical assessment and intervention in school contexts. Show more

Keywords: Social cognition, theory of mind, adolescent, emotion recognition

DOI: 10.3233/NRE-2008-23606

Citation: NeuroRehabilitation, vol. 23, no. 6, pp. 501-509, 2008

Authors: Kennedy, Mary R.T. | Krause, Miriam O. | Turkstra, Lyn S.

Article Type: Research Article

Abstract: For many with traumatic brain injury (TBI), going to college is a realistic goal; however there is little documentation of the challenges faced by those with TBI who attend college. The primary purposes of this study were to document the academic challenges (studying, in-class experiences, time management, psychosocial aspects) reported by adults with TBI, and to investigate relationships between these challenges and the physical, cognitive and psychosocial consequences of TBI. An electronic anonymous survey was distributed. Of the 35 respondents with TBI, nearly all reported the need to review material more and a majority reported that others do not understand …their problems. In-class experiences of being nervous before tests, forgetting what is said in class, and getting overwhelmed in class were also reported by a majority. Those who reported more physical, cognitive and psychosocial consequences of their injury also identified more academic challenges as well, although cognitive consequences alone predicted academic challenges better than all of the consequences combined. Psychosocial aspects also predicted academic challenges to a lesser extent. In spite of these findings, nearly half of the respondents had not heard of or had never accessed campus disability services. To develop effective on-campus service delivery models, additional research is needed to understand why students do or do not make use of existing services. Show more

Keywords: College, post-secondary education, study skills, cognition, psychosocial, services, higher education

DOI: 10.3233/NRE-2008-23607

Citation: NeuroRehabilitation, vol. 23, no. 6, pp. 511-520, 2008

Authors: MacLennan, Don L. | MacLennan, Diane C.

Article Type: Research Article

Abstract: Approximately 1.4 million Americans sustain a traumatic brain injury (TBI) each year with approximately two-thirds of these injuries affecting people between the ages of 15 and 24 years. Consequently, many adults with brain injury sustain their injuries during a time when they are making important decisions regarding future vocational activities, including return to school. Cognitive impairments resulting from TBI present as a significant barrier to return to school and it is difficult to predict those persons who will succeed in school after a TBI and those who will not. This article presents a college simulation experience currently used in a …rehabilitation setting. It involves lectures and examinations that test an individual's ability to learn new material. Lecture content focuses on the nature and effects of brain injury and on study skills. In addition, compensatory strategies commonly used in university settings (note takers, extended time for exams, taped lectures) may be used to assess potential benefit of these services. The simulated college experience provides a realistic appraisal of the individual's ability to learn information in a lecture-oriented class setting. It also provides information regarding the benefits of specific study skills and compensatory strategies. Case studies of three individuals with severe TBI are presented. Show more

Keywords: Traumatic brain injury, rehabilitation, vocational rehabilitation, career counseling, higher education, treatment outcomes

DOI: 10.3233/NRE-2008-23608

Citation: NeuroRehabilitation, vol. 23, no. 6, pp. 521-528, 2008

Authors: Proctor, Adele | Zhang, Jie

Article Type: Research Article

Abstract: The purpose of this study was to determine if race/ethnicity may influence performance of college students on the Behavioral Assessment of Dysexecutive Syndrome (BADS) and the Wisconsin Card Sorting Test (WCST), two different tests of executive function (EF). A total of 149 participants who self-identified as African American (AA), European American (EA), and Latina/o American (LA) constituted the three different racial/ethnic groups. Participants ranged in age range from 18 to 24 years old (SD = 1.29) and none reported histories of disabilities. The BADS was administered to 149 college students and the WCST was administered to 142 of the …same participants. No statistically significant differences were found for race/ethnicity or gender on the WCST. Statistically significant differences were found for race/ethnicity on the Profile Scores (raw scores), standard scores (SS) and the Zoo Map subtest of the BADS, but no statistically significant differences were found for gender on these same tasks. While there should be less concern in administering WCST to diverse groups who are English speakers, caution should be taken in administering and interpreting the BADS for individuals from diverse cultural and linguistic backgrounds. Show more

Keywords: Executive function, BADS, WCST, race/ethnicity, executive dysfunction

DOI: 10.3233/NRE-2008-23609

Citation: NeuroRehabilitation, vol. 23, no. 6, pp. 529-536, 2008

Article Type: Correction

DOI: 10.3233/NRE-2008-23610

Citation: NeuroRehabilitation, vol. 23, no. 6, pp. 537-537, 2008