Paediatric traumatic brain injury and the dysregulation profile: The mediating role of decision-making

Abstract

Decision-making is often impacted by paediatric traumatic brain injury (TBI). However, there are few tools available to assess these skills in children, with even less research on the consequences of decision-making deficits on dysregulation following TBI. This prospective preliminary study investigated whether decision-making mediated the effect of TBI on dysregulation in children. The performance of school-aged children aged between 7 and 15 years with TBI (n = 49) and that of typically developing controls (n = 22) was compared on The Decision-making Task, and on parent ratings of the dysregulation profile as characterized by the Child Behaviour Checklist-Dysregulation Profile. Relative to the Control group, the TBI group performed more poorly on the decision-making task, and parents of the TBI group rated their children to be more poorly on the dysregulation profile. Mediation analyses indicated that decision-making mediated the relationship between TBI and the dysregulation profile. Our preliminary findings suggest the need for further research in the area of decision-making, and its impact on dysregulated behaviours in children following TBI.

Rehabilitation of Executive Function in Pediatric Traumatic Brain Injury (REPeaT): Outcomes of a pilot randomized controlled trial.

“…An experimental computerized test was used to measure DM. The Decision-Making Task (DMT; Sood, Godfrey, Chavez Arana, et al, 2023; Sood, Godfrey, Youn, et al, 2023) presented the participants with three real-world decision scenarios in an information-board matrix of six attributes and three alternatives for each of the decision scenario. The task required the participants to select both their least and most preferred attributes, search relevant information in the information-board to make a subsequent final choice, and answer a series of questions pertaining to their preferences for each of the three decision scenarios (Klayman, 1985).…”

“…Higher scores indicated better DM. DMT is a novel experimental measure, with internal consistency reliability of 0.627 and good convergent validity with the measures of WM, functional measures, and behavior (Sood, Godfrey, Chavez Arana, et al, 2023).…”

The Australian and New Zealand brain injury lifespan cohort protocol: Leveraging common data elements to characterise longitudinal outcome and recovery

“…While preinjury and injury-related risk factors are often not modifiable, they allow us to identify children most ‘at risk’ and therefore a preventative approach to intervention can be implemented. Children with these risk factors are often vulnerable to persisting, long-term impairments, so they may be invited to take part in intervention programmes aiming to prevent and/or reduce difficulties such as attention, memory and executive impairments 5 26 27. Other factors may be more modifiable, including parent mental health and family dysfunction, where direct resources (eg, psychoeducation in the form of parenting programmes) may improve child behaviour and reduce parental anxiety 28…”