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Related Concept Videos

Traumatic Brain Injury l: Introduction01:28

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...
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Modeling, a key technique in therapy, uses observational learning to help clients acquire and practice new skills by watching therapists demonstrate desired behaviors. This approach, rooted in Albert Bandura's concept of vicarious learning, plays a significant role in therapeutic interventions for various psychological conditions, including social anxiety, ADHD, and depression.
Participant Modeling
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Online problem-solving therapy for executive dysfunction after child traumatic brain injury.

Brad G Kurowski1, Shari L Wade, Michael W Kirkwood

  • 1Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, USA. brad.kurowski@cchmc.org

Pediatrics
|June 12, 2013
PubMed
Summary

Web-based counselor-assisted problem solving (CAPS) significantly improved executive functioning in adolescents after traumatic brain injury (TBI). This intervention showed better results than an internet resource comparison for treating executive dysfunction post-TBI.

Keywords:
adolescentbrain injurychildexecutive functiononlinetherapy

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Area of Science:

  • Neuroscience
  • Pediatric Medicine
  • Rehabilitation Psychology

Background:

  • Executive dysfunction is a common and impairing consequence of traumatic brain injury (TBI) in children.
  • Adolescents with TBI often experience difficulties in daily functioning due to executive dysfunction.

Purpose of the Study:

  • To evaluate the effectiveness of a web-based counselor-assisted problem solving (CAPS) intervention for executive dysfunction in adolescents post-TBI.
  • To compare CAPS efficacy against an internet resource comparison (IRC) within 12 months of injury.

Main Methods:

  • A multisite, randomized controlled trial involving 132 adolescents (aged 12-17) with complicated mild to severe TBI.
  • Assessor-blinded design with outcomes measured using the Behavioral Rating Inventory of Executive Function (BRIEF) Global Executive Composite at baseline and 6-month follow-up.
  • Generalized linear models were used to compare groups, controlling for baseline scores.

Main Results:

  • Older adolescents in the CAPS group demonstrated significant improvements in executive function behaviors at 6-month follow-up compared to the IRC group (P = .01).
  • The CAPS intervention showed a moderate effect size (Cohen's d = 0.63).

Conclusions:

  • Web-based CAPS is effective in improving caregiver-rated executive functioning in older adolescents within the first year after TBI.
  • Further research should identify optimal timing for CAPS delivery and patient/family characteristics that predict benefit.