Abstract

Objective: The study explored the neurocognitive profiles of pediatric patients with moderate/severe traumatic brain injury (TBI) at 3 (Time-1) and 12 months (Time-2) post injury. Previous research suggests deficits in cognition, attention, working memory, and processing speed. The current study was done to further explore these neurocognitive concerns in children with TBI. Method: 69 moderate/severe pediatric TBI patients ages 6–16 (73% male, mean age Time-1 = 11yrs, SD = 3.9; mean age Time-2 = 12yrs, SD = 3.7) completed Children's Memory Scale (CMS), Test of Everyday Attention-Children (TEA-Ch), and Wechsler Abbreviated Scale of Intelligence (WASI) 3-months and 12-months post injury. Results were compared to 69 age-matched healthy controls (73% male, mean age Time-1 = 12 years, SD = 3.4; mean age Time-2 = 13 years, SD = 3.3) assessed twice 12 months apart. Results: Descriptive and Paired t-tests were conducted revealing no significant differences in cognitive summary scores, memory indices, or TEA-Ch scores across both time points within groups (see Table 1). However, trends revealed increase in scores from Time-1 to Time-2 with control group performance significantly better across all measures at both time points. Conclusion(s): Consistent with current literature, neurocognitive profiles in this Moderate/Severe TBI population exhibited lower IQ, Memory, and Attention scores than healthy Controls. A within subjects pattern was noted indicating that children's whose scores were lower at Time-1 demonstrated limited improvement at Time-2. Conversely, subjects whose scores that were higher at Time-1 were more likely to demonstrate stronger improvement at Time-2.

Table 1.

TBI and Control Neurocognitive Indices/Scaled scores

 Full Scale IQ (FSIQ) Performance IQ (PIQ) Verbal IQ (VIQ) General Memory Verbal Immediate Verbal Delayed Visual Immediate Visual Delayed Learning Delayed Recognition 
3 months post-injury, Time 1
N = 57 
M= 90.3
(SD =13.5)
M= 103.6
(SD =18.6) 
M= 93.4
(SD= 14.4)
M= 105.9
(SD =15.0) 
M = 89.1
(SD =14.2)
M= 102.1
(SD =15.6) 
M= 92.6 (SD = 20.8)
M= 109.5
(SD =17.3) 
M= 91.3
(SD = 18.9)
M= 105.5
(SD =16.3) 
M= 92.1 (SD = 19.8)
M= 109.9
(SD =17.2) 
M= 95.3 (SD = 17.8)
M= 104.9
(SD =12.2) 
M= 96.6
(SD = 17.2)
M= 104.8
(SD =12.6) 
M= 93.5 (SD = 19.6)
M= 104.9
(SD =16.0) 
M= 92.8
(SD = 17.3)
M= 102.5
(SD =14.4) 
12 months post-injury,
Time 2
N = 57 
M= 93.1
(SD =12.8)
M= 109.3
(SD =14.6) 
M= 97.1
(SD = 13.0)
M= 108.3
(SD =15.3) 
M= 91.9 (SD = 14.7)
M= 107.8
(SD =14.2) 
M= 103.9 (SD = 22.2)
M= 120.5
(SD =14.5) 
M= 96.1
(SD = 19.0)
M= 111.3
(SD =16.9) 
M= 97.5 (SD = 18.9)
M= 115.1
(SD =15.6) 
M= 107.0 (SD = 18.9)
M= 115
(SD =12.8) 
M= 109.2 (SD = 16.2)
M= 114.7
(SD =11.9) 
M= 98.9 (SD = 19.3)
M= 110.3
(SD =14.6) 
M= 94.7
(SD = 17.7)
M= 104.9
(SD =13.5) 
*WASI & CMS scores based on standard scores with M = 100, SD = 15 
 TEA-Ch:
Correct Targets 
TEA-Ch:
Time per Target 
TEA-Ch:
Attention Score 
TEA-Ch:
Score! 
TEA-Ch:
Creature Counting 
TEA-Ch:
Sky Search DT 
TEA-Ch:
Map Mission 
TEA-Ch:
Score DT 
TEA-Ch:
Walk/Don't Walk 
 
3 months post-injury, Time 1
N = 57 
M= 9.1
(SD =3.5)
M= 8.9
(SD =4.2) 
M= 8.1
(SD= 3.7)
M= 9.3
(SD =3.0) 
M = 8.9
(SD =3.6)
M= 9.2
(SD =3.1) 
M= 8.4
(SD = 3.2)
M= 9.2
(SD =3.0) 
M= 9.6
(SD = 3.4)
M= 12.1
(SD =3.3) 
M= 6.7
(SD = 4.2)
M= 8.1
(SD =3.7) 
M= 7.3
(SD = 3.2)
M= 7.6
(SD =3.1) 
M= 7.8
(SD = 3.3)
M= 11.2
(SD =3.4)
 
M= 6.7
(SD = 3.4)
M= 9.6
(SD =3.2) 
 
12 months post-injury,
Time 2
N = 57 
M= 9.8
(SD =3.2)
M= 13.2
(SD =3.9) 
M= 9.8
(SD = 3.5)
M= 13.3
(SD =3.4) 
M= 10.6 (SD = 3.7)
M= 13.1
(SD =3.3) 
M= 8.7 (SD = 3.5)
M= 12.3
(SD =3.0) 
M= 10.3
(SD = 2.9)
M= 14.4
(SD =3.5) 
M= 8.6
(SD = 3.7)
M= 9.2
(SD =3.6) 
M= 7.2
(SD = 4.1)
M= 10.1
(SD =3.1) 
M= 8.0
(SD = 3.6)
M= 8.2
(SD =4.1) 
M= 9.3
(SD = 3.0)
M= 10.3
(SD =3.3) 
 
 Full Scale IQ (FSIQ) Performance IQ (PIQ) Verbal IQ (VIQ) General Memory Verbal Immediate Verbal Delayed Visual Immediate Visual Delayed Learning Delayed Recognition 
3 months post-injury, Time 1
N = 57 
M= 90.3
(SD =13.5)
M= 103.6
(SD =18.6) 
M= 93.4
(SD= 14.4)
M= 105.9
(SD =15.0) 
M = 89.1
(SD =14.2)
M= 102.1
(SD =15.6) 
M= 92.6 (SD = 20.8)
M= 109.5
(SD =17.3) 
M= 91.3
(SD = 18.9)
M= 105.5
(SD =16.3) 
M= 92.1 (SD = 19.8)
M= 109.9
(SD =17.2) 
M= 95.3 (SD = 17.8)
M= 104.9
(SD =12.2) 
M= 96.6
(SD = 17.2)
M= 104.8
(SD =12.6) 
M= 93.5 (SD = 19.6)
M= 104.9
(SD =16.0) 
M= 92.8
(SD = 17.3)
M= 102.5
(SD =14.4) 
12 months post-injury,
Time 2
N = 57 
M= 93.1
(SD =12.8)
M= 109.3
(SD =14.6) 
M= 97.1
(SD = 13.0)
M= 108.3
(SD =15.3) 
M= 91.9 (SD = 14.7)
M= 107.8
(SD =14.2) 
M= 103.9 (SD = 22.2)
M= 120.5
(SD =14.5) 
M= 96.1
(SD = 19.0)
M= 111.3
(SD =16.9) 
M= 97.5 (SD = 18.9)
M= 115.1
(SD =15.6) 
M= 107.0 (SD = 18.9)
M= 115
(SD =12.8) 
M= 109.2 (SD = 16.2)
M= 114.7
(SD =11.9) 
M= 98.9 (SD = 19.3)
M= 110.3
(SD =14.6) 
M= 94.7
(SD = 17.7)
M= 104.9
(SD =13.5) 
*WASI & CMS scores based on standard scores with M = 100, SD = 15 
 TEA-Ch:
Correct Targets 
TEA-Ch:
Time per Target 
TEA-Ch:
Attention Score 
TEA-Ch:
Score! 
TEA-Ch:
Creature Counting 
TEA-Ch:
Sky Search DT 
TEA-Ch:
Map Mission 
TEA-Ch:
Score DT 
TEA-Ch:
Walk/Don't Walk 
 
3 months post-injury, Time 1
N = 57 
M= 9.1
(SD =3.5)
M= 8.9
(SD =4.2) 
M= 8.1
(SD= 3.7)
M= 9.3
(SD =3.0) 
M = 8.9
(SD =3.6)
M= 9.2
(SD =3.1) 
M= 8.4
(SD = 3.2)
M= 9.2
(SD =3.0) 
M= 9.6
(SD = 3.4)
M= 12.1
(SD =3.3) 
M= 6.7
(SD = 4.2)
M= 8.1
(SD =3.7) 
M= 7.3
(SD = 3.2)
M= 7.6
(SD =3.1) 
M= 7.8
(SD = 3.3)
M= 11.2
(SD =3.4)
 
M= 6.7
(SD = 3.4)
M= 9.6
(SD =3.2) 
 
12 months post-injury,
Time 2
N = 57 
M= 9.8
(SD =3.2)
M= 13.2
(SD =3.9) 
M= 9.8
(SD = 3.5)
M= 13.3
(SD =3.4) 
M= 10.6 (SD = 3.7)
M= 13.1
(SD =3.3) 
M= 8.7 (SD = 3.5)
M= 12.3
(SD =3.0) 
M= 10.3
(SD = 2.9)
M= 14.4
(SD =3.5) 
M= 8.6
(SD = 3.7)
M= 9.2
(SD =3.6) 
M= 7.2
(SD = 4.1)
M= 10.1
(SD =3.1) 
M= 8.0
(SD = 3.6)
M= 8.2
(SD =4.1) 
M= 9.3
(SD = 3.0)
M= 10.3
(SD =3.3) 
 

*TEA-Ch scores are based on scaled scores with M = 10, SD = 3

**Healthy Control scores are coded gray.