Profiles of cold executive function performance among pediatric acquired brain injury

Darpan Kaur Aulakh · Palak Upadhyay · Gursabeen Kaur · Jatinder Singh Goraya · BP Mishra

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Developmental and Educational Neuropsychology Traumatic Brain Injury Research Cognitive Functions and Memory

Abstract

OBJECTIVE: To compare cold executive functioning (EF) among children with perinatal ischemic stroke (PAS), traumatic brain injury (TBI), and brain tumors (BT), and to delineate distinct neuropsychological profiles across these acquired brain injury (ABI) subtypes. METHOD: A cross-sectional neuropsychological assessment was conducted on children aged 6 to 18 years divided into three study groups: PAS (n = 22), TBI (n = 17), and BT (n = 11) with each participant matched to a control (1:1) based on age, gender, and educational attainment resulting in three control groups. Participants were screened for 'intellectual impairment' as per Raven's Progressive Matrices. Standardized tests measuring planning (Rey Osterrieth Complex Figure test), sustained attention (Color Cancelation Test), focused attention (Color Trails Test), working memory (Digit Span), verbal fluency (Phonemic fluency test), visuo-constructive (Block Design), and visuo-conceptual tasks (Picture Completion Test) were administered. Group comparisons were conducted using non-parametric and ANCOVA analyses with age and gender adjustments. RESULTS: A heterogeneous pattern of cold executive dysfunction across the three ABI etiologies was found. Trends indicate TBI > BT > PAS for attention and working memory; for verbal fluency PAS > TBI > BT; and BT > TBI > PAS for planning. Age controlled post hoc differences reveal significant dysfunction in PAS group for planning, visuo-conceptual and visuo-constructive abilities. Post hoc effects controlled for gender revealed significant dysfunction for visuo-conceptual and visuo-constructive ability. CONCLUSIONS: Distinct executive function profiles were observed across ABI subtypes, with PAS associated with the most pervasive impairments, TBI with selective deficits, and BT with targeted planning difficulties. These findings highlight the importance of tailored cognitive rehabilitation strategies based on ABI subtype.

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References

1999Normative Data Stratified by Age and Education for Two Measures of Verbal Fluency FAS and Animal Naming 2006Clinical and empirical applications of the Rey–Osterrieth Complex Figure Test 2020The neurodevelopment of executive function skills: Implications for academic achievement gaps.2000The Boston Qualitative Scoring System as a Measure of Executive Functioning in Rey-Osterrieth Complex Figure Performance 2017Digit Span Subscale Scores May Be Insufficiently Reliable for Clinical Interpretation: Distinguishing Between Stratified Coefficient Alpha and Omega Hierarchical 2022Executive functions and psychosocial impairment in children following arterial ischemic stroke

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