title: Assessment of executive functioning in children after TBI with a naturalistic open-ended task: a pilot study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: INR A. Hôpital National de Saint Maurice, Saint Maurice, France. m.chevignard@hopital-saint-maurice.fr
authors.forename: Mathilde P
authors.initials: MP
authors.lastname: Chevignard
authors.forename: Violette
authors.initials: V
authors.lastname: Servant
authors.forename: Aude
authors.initials: A
authors.lastname: Mariller
authors.forename: Geneviève
authors.initials: G
authors.lastname: Abada
authors.forename: Pascale
authors.initials: P
authors.lastname: Pradat-Diehl
authors.forename: Anne
authors.initials: A
authors.lastname: Laurent-Vannier