title: Adaptive functioning following pediatric traumatic brain injury: Relationship to executive function and processing speed.
abstract: Pediatric traumatic brain injury (TBI) may affect children's ability to perform everyday tasks (i.e., adaptive functioning). Guided by the American Association for Intellectual and Developmental Disabilities (AAIDD) model, we explored the association between TBI and adaptive functioning at increasing levels of specificity (global, AAIDD domains, and subscales). We also examined the contributions of executive function and processing speed as mediators of TBI's effects on adaptive functioning.
  
  
  
  Children (ages 8-13) with severe TBI (STBI; n = 19), mild-moderate TBI (MTBI; n = 50), or orthopedic injury (OI; n = 60) completed measures of executive function (TEA-Ch) and processing speed (WISC-IV) an average of 2.7 years postinjury (SD = 1.2; range: 1-5.3). Parents rated children's adaptive functioning (ABAS-II, BASC-2, CASP).
  
  
  
  STBI had lower global adaptive functioning (η2 = .04-.08) than the MTBI and OI groups, which typically did not differ. Deficits in the STBI group were particularly evident in the social domain, with specific deficits in social participation, leisure, and social adjustment (η2 = .06-.09). Jointly, executive function and processing speed were mediators of STBI's effects on global adaptive functioning and in conceptual and social domains. In the STBI group, executive function mediated social functioning, and processing speed mediated social participation.
  
  
  
  Children with STBI experience deficits in adaptive functioning, particularly in social adjustment, with less pronounced deficits in conceptual and practical skills. Executive function and processing speed may mediate the effects of STBI on adaptive functioning. Targeting adaptive functioning and associated cognitive deficits for intervention may enhance quality of life for pediatric TBI survivors. (PsycINFO Database Record
authors.affiliation: Research Institute at Nationwide Children's Hospital.
authors.forename: Emily L
authors.identifier: 0000-0002-0207-0251
authors.initials: EL
authors.lastname: Shultz
authors.affiliation: Department of Pediatrics.
authors.forename: Kristen R
authors.initials: KR
authors.lastname: Hoskinson
authors.affiliation: Research Institute at Nationwide Children's Hospital.
authors.forename: Madelaine C
authors.initials: MC
authors.lastname: Keim
authors.affiliation: Department of Psychology, Hospital for Sick Children.
authors.forename: Maureen
authors.initials: M
authors.lastname: Dennis
authors.affiliation: Division of Developmental and Behavioral Pediatrics and Psychology.
authors.forename: H Gerry
authors.initials: HG
authors.lastname: Taylor
authors.affiliation: Department of Psychology.
authors.forename: Erin D
authors.initials: ED
authors.lastname: Bigler
authors.affiliation: Department of Human Development and Quantitative Methodology, University of Maryland.
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Rubin
authors.affiliation: Department of Pediatrics.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Vannatta
authors.affiliation: Department of Pediatrics.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Gerhardt
authors.affiliation: Division of Pediatric Psychology, Department of Pediatrics.
authors.forename: Terry
authors.initials: T
authors.lastname: Stancin
authors.affiliation: Department of Psychology, Alberta Children's Hospital Research Institute.
authors.forename: Keith Owen
authors.initials: KO
authors.lastname: Yeates
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001925:Brain Damage, Chronic / Q000175:diagnosis* / Q000523:psychology*; D000070642:Brain Injuries, Traumatic / Q000175:diagnosis* / Q000523:psychology*; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology*; D056344:Executive Function; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care; D011930:Reaction Time