Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Department of Psychology, University of Cincinnati, Cincinnati, OH, USA.
Child Neuropsychol. 2024 Nov;30(8):1203-1214. doi: 10.1080/09297049.2024.2314957. Epub 2024 Feb 13.
Deficits in executive functioning (EF) behaviors are very common following pediatric traumatic brain injury (TBI) and can linger well after acute injury recovery. Raters from multiple settings provide information that may not be appreciated otherwise. We examined differences between parent and teacher ratings of EF using data examining longitudinal outcomes following pediatric TBI in comparison to orthopedic injury (OI). We used linear mixed models to determine the association of rater type and injury type with scores on the Behavior Rating Inventory of Executive Functioning (BRIEF). After controlling for demographic variables, rater type and injury type accounted for a small but significant proportion of the variance in EF. Teachers' ratings on the BRIEF were significantly higher than parent ratings for global EF and metacognition, but not for behavior regulation, regardless of injury type, indicating greater EF concerns. All BRIEF ratings, whether from teachers or parents, were higher for children with TBI than for those with OI. Results suggest that parents and teachers provide unique information regarding EF following traumatic injuries and that obtaining ratings from persons who observe children at school as well as at home can result in a better understanding of situation-specific variability in outcomes.
执行功能 (EF) 行为缺陷在儿童创伤性脑损伤 (TBI) 后非常常见,并且在急性损伤恢复后很长时间内仍会存在。来自多个环境的评估者提供的信息可能 otherwise 无法得到重视。我们使用数据检查了儿科 TBI 后与骨科损伤 (OI) 进行纵向结果比较的父母和教师对 EF 的评估之间的差异。我们使用线性混合模型来确定评估者类型和损伤类型与行为评估执行功能 (BRIEF) 得分之间的关联。在控制人口统计学变量后,评估者类型和损伤类型占 EF 方差的一小部分,但具有统计学意义。教师对 BRIEF 的评分在总体 EF 和元认知方面显著高于家长评分,但行为调节方面则不然,这表明 EF 问题更严重。无论损伤类型如何,患有 TBI 的儿童的所有 BRIEF 评分均高于患有 OI 的儿童,这表明他们的 EF 问题更严重。研究结果表明,父母和教师提供了有关创伤性损伤后 EF 的独特信息,并且从观察儿童在学校和家庭中的人员那里获得评分可以更好地了解特定情况下结果的变异性。