Daily executive functioning in adults with pediatric hemispherectomy.

Area of Science:

• Neuroscience
• Developmental Psychology
• Clinical Psychology

Background:

• Pediatric hemispherectomy surgery (pHS) is a critical intervention for intractable epilepsy in children.
• While motor and sensory outcomes are predictable, long-term cognitive and functional effects of pHS vary.
• This study investigates executive functioning and self-awareness in adults post-pHS with preserved general cognition.

Purpose of the Study:

• To identify potential targets for post-pHS interventions.
• To examine daily executive functioning and self-awareness in adults who had pHS.
• To assess adults with pHS and average or above intelligence test performance.

Main Methods:

• Utilized the Behavior Rating Inventory of Executive Functioning, Adult Version (BRIEF-A) for self- and informant-ratings.
• Evaluated adaptive behavior in 16 adults with pHS and Full-Scale IQ ≥ 77.
• Compared participant and informant reports to normative data and analyzed discrepancy scores.

Main Results:

• Both self- and informant-reports indicated executive functioning generally aligned with age-matched norms.
• Participants with pHS reported better self-monitoring than peers, potentially indicating compensation for sensory-motor deficits.
• A notable discrepancy was observed in initiation, with participants rating themselves as less impaired than informants did.

Conclusions:

• Adults with average general cognition post-pHS exhibit largely typical daily executive functioning.
• Potential areas for intervention include self-monitoring and initiation, where self-perceptions may differ from informant observations.
• Findings suggest that while overall cognition is preserved, specific executive functions may warrant targeted support.