Chevignard Mathilde P, Servant Violette, Mariller Aude, Abada Geneviève, Pradat-Diehl Pascale, Laurent-Vannier Anne
INR A. Hôpital National de Saint Maurice, Saint Maurice, France.
Dev Neurorehabil. 2009 Apr;12(2):76-91. doi: 10.1080/17518420902777019.
Traumatic brain injury (TBI) often leads to executive functions (EF) deficits, resulting in severe longstanding disabilities in daily life activities. The sensitivity and ecological validity of neuropsychological tests have been questioned. The aim of this study was to pilot a novel open-ended naturalistic task and to compare it to other standardized assessments of EF in children post-TBI.
Ten children aged 8-14, with moderate-to-severe TBI, and 18 matched controls participated in the study. The clinical group was assessed using cognitive tests and parent-based questionnaires of EF. An interactive ecological cooking task was designed.
Analyses indicated mild-to-moderate executive deficits in the cognitive tests in approximately half of the TBI group. For the experimental cooking task, all quantitative and qualitative variables were significantly impaired for the TBI group compared to the control group and failure in the cooking task was associated with lower scores in cognitive tests of EF. The task was able to discriminate the TBI children from the control group.
This pilot study highlights the role of naturalistic assessments, to complement standardized tests in assessing patients' dysexecutive impairments in complex activities of daily living post-childhood TBI.
创伤性脑损伤（TBI）常导致执行功能（EF）缺陷，从而在日常生活活动中造成严重的长期残疾。神经心理学测试的敏感性和生态效度受到了质疑。本研究的目的是试行一项新型的开放式自然任务，并将其与TBI患儿的其他标准化EF评估进行比较。
10名年龄在8至14岁、患有中度至重度TBI的儿童以及18名匹配的对照组儿童参与了该研究。临床组通过认知测试和基于家长的EF问卷进行评估。设计了一项交互式生态烹饪任务。
分析表明，TBI组中约一半儿童在认知测试中存在轻度至中度执行功能缺陷。对于实验性烹饪任务，与对照组相比，TBI组的所有定量和定性变量均有显著受损，且烹饪任务失败与EF认知测试得分较低相关。该任务能够区分TBI儿童和对照组儿童。
这项初步研究强调了自然评估在补充标准化测试以评估儿童期TBI后患者在复杂日常生活活动中的执行功能障碍方面的作用。
