Sluggish cognitive tempo in children with traumatic brain injuries
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Published on: May 7, 2021
Seema Mahdavi1, Emily Hasper2, Jacobus Donders1
1Psychology Service, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA.
Insights
This study found no link between sluggish cognitive tempo (SCT) and processing speed in children with traumatic brain injury (TBI). The Child Behavior Checklist (CBCL) may not effectively measure TBI-related cognitive changes.
Area of Science:
- Neuroscience
- Pediatric Psychology
- Rehabilitation Medicine
Background:
- Traumatic brain injury (TBI) in children can lead to persistent cognitive deficits.
- Sluggish cognitive tempo (SCT) is a construct characterized by daytime sleepiness and cognitive slowing.
- The relationship between SCT and processing speed deficits post-TBI remains under-explored.
Purpose of the Study:
- To investigate the association between SCT and processing speed in pediatric TBI.
- To examine the influence of injury severity and pre-morbid factors on this relationship.
- To determine if SCT, measured by the CBCL, is a sensitive indicator of TBI sequelae.
Main Methods:
- Evaluated SCT using the Child Behavior Checklist (CBCL) in 50 children (ages 6-16) with TBI.
- Assessed processing speed with the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV Processing Speed Index).
- Considered injury variables (coma length, neuroimaging) and cognitive reserve (parental education).
Main Results:
- No significant correlations were found between SCT and WISC-IV index scores.
- Children with moderate-severe TBI had lower processing speed than those with mild TBI, but similar SCT scores.
- Parental education did not correlate significantly with SCT or processing speed.
Conclusions:
- SCT, as measured by the CBCL, does not appear to be a sensitive marker for cognitive sequelae in pediatric TBI.
- Processing speed deficits are evident in moderate-severe pediatric TBI, but not necessarily captured by SCT measures.
- Further research is needed to identify sensitive cognitive measures for TBI in children.
Abstract:
This exploratory study is the first to investigate whether the construct of sluggish-cognitive tempo (SCT) is related to slowed processing speed in children with traumatic brain injury (TBI), while also considering pre-morbid and injury variables. The study evaluated SCT, as measured by the Child Behavior Checklist (CBCL), and processing speed, as assessed with the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV Processing Speed Index), in children who sustained TBI with a wide range of injury severity. Injury variables examined included the length of coma, presence of neuroimaging findings, and time between injury and assessment. Children's cognitive reserve, as estimated by parental level of education, was a non-injury variable. The participants included 50 children, ages 6-16 years, without co-morbid neurological or psychiatric conditions who underwent a neuropsychological evaluation within 1-12 months after injury. Results indicated no significant correlations between SCT and any of the WISC-IV index scores. Children with a moderate-severe TBI did not differ from those with uncomplicated mild TBI on SCT but they had statistically significant lower WISC-IV Processing Speed. Although parents of children with uncomplicated mild TBI had higher levels of education as compared to parents of children with moderate-severe TBI, there was no statistically significant relationship between the level of parental education and either SCT or Processing Speed. This study suggests that SCT, as measured by the CBCL, is not a sensitive measure of sequelae of pediatric TBI.
