학술논문
More to the story than executive function: Effortful control soon after injury predicts long-term functional and social outcomes following pediatric traumatic brain injury in young children.
Document Type
Academic Journal
Author
Smith-Paine J; Cincinnati Children's Hospital Medical Center, Cincinnati, USA.; Moscato EL; Cincinnati Children's Hospital Medical Center, Cincinnati, USA.; University of Cincinnati, Cincinnati, USA.; Narad ME; Cincinnati Children's Hospital Medical Center, Cincinnati, USA.; University of Cincinnati, Cincinnati, USA.; Sensenbaugh J; Cincinnati Children's Hospital Medical Center, Cincinnati, USA.; Wright State University, Dayton, USA.; Ling B; Cincinnati Children's Hospital Medical Center, Cincinnati, USA.; Wright State University, Dayton, USA.; Taylor HG; Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.; Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA.; Stancin T; Case Western Reserve University, Cleveland, USA.; MetroHealth Medical Center, Cleveland, USA.; Yeates KO; University of Calgary, Calgary, Canada.; Wade SL; Cincinnati Children's Hospital Medical Center, Cincinnati, USA.; University of Cincinnati, Cincinnati, USA.
Source
Publisher: Cambridge University Press Country of Publication: England NLM ID: 9503760 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1469-7661 (Electronic) Linking ISSN: 13556177 NLM ISO Abbreviation: J Int Neuropsychol Soc Subsets: MEDLINE
Subject
Language
English
Abstract
Objective: To examine the impact of early traumatic brain injury (TBI) on effortful control (EC) over time and the relationship of EC and executive functioning (EF) to long-term functional and social outcomes.
Method: Parents of children ( N = 206, ages 3-7) with moderate-to-severe TBI or orthopedic injuries (OIs) rated EC using the Child Behavior Questionnaire at 1 (pre-injury), 6, 12, and 18 months post-injury. Child functioning and social competence were assessed at 7 years post-injury. Mixed models examined the effects of injury, time since injury, and their interaction on EC. General linear models examined the associations of pre-injury EC and EC at 18 months with long-term functional and social outcomes. Models controlled for EF to assess the unique contribution of EC to outcomes.
Results: Children with severe TBI had significantly lower EC than both the OI and moderate TBI groups at each post-injury time point. Both pre-injury and 18-month EC were associated with long-term outcomes. Among those with low EC at baseline, children with moderate and severe TBI had more functional impairment than those with OI; however, no group differences were noted at high levels of EC. EC had main effects on parent-reported social competence that did not vary by injury type.
Conclusions: Findings suggest that EC is sensitive to TBI effects and is a unique predictor of functional outcomes, independent of EF. High EC could serve as a protective factor, and as such measures of EC could be used to identify children for more intensive intervention.
Method: Parents of children ( N = 206, ages 3-7) with moderate-to-severe TBI or orthopedic injuries (OIs) rated EC using the Child Behavior Questionnaire at 1 (pre-injury), 6, 12, and 18 months post-injury. Child functioning and social competence were assessed at 7 years post-injury. Mixed models examined the effects of injury, time since injury, and their interaction on EC. General linear models examined the associations of pre-injury EC and EC at 18 months with long-term functional and social outcomes. Models controlled for EF to assess the unique contribution of EC to outcomes.
Results: Children with severe TBI had significantly lower EC than both the OI and moderate TBI groups at each post-injury time point. Both pre-injury and 18-month EC were associated with long-term outcomes. Among those with low EC at baseline, children with moderate and severe TBI had more functional impairment than those with OI; however, no group differences were noted at high levels of EC. EC had main effects on parent-reported social competence that did not vary by injury type.
Conclusions: Findings suggest that EC is sensitive to TBI effects and is a unique predictor of functional outcomes, independent of EF. High EC could serve as a protective factor, and as such measures of EC could be used to identify children for more intensive intervention.