Self-awareness assessment during cognitive rehabilitation in children with acquired brain injury: a feasibility study and proposed model of child anosognosia

Abstract

Self-awareness has multiple components that need to be assessed separately, to better adapt cognitive rehabilitation. Using questionnaires and discrepancy scores are not sufficient to assess awareness, because it does not include on-line error detection, which can be massively impaired in children, especially those with impaired executive functions. On-line error detection is important to promote and error-based learning is useful to allow a child to build a self-knowledge of his/her strengths and difficulties, in the absence of severe episodic memory problems. Metacognitive trainings may not be appropriate for younger children who have age appropriate developmentally immature self-awareness, nor for patients with brain injury if they suffer anosognosia because of their brain injury.

Cognitive Intervention for Attention and Executive Function Impairments in Children With Traumatic Brain Injury: A Pilot Study

“…This finding may reflect impairments in deficit awareness or self-monitoring, common in individuals with TBI. [53][54][55] Although impairments in deficit awareness are most often discussed with regard to limited awareness of the presence of cognitive deficits, it is likely that individuals with TBI also have difficulty monitoring improvements in their cognitive skills. It is also plausible that individuals whose self-monitoring and deficit awareness improve because of an intervention (or recovery) might begin reporting more cognitive problems than before the intervention as they become more aware of remaining deficits.…”

Evidence-based systematic review of cognitive rehabilitation, emotional, and family treatment studies for children with acquired brain injury literature: From 2006 to 2017

“…A third supported the ease of use and acceptability of a web-based videoconference training program of a problem-solving intervention to family identified goals [36] . Two pilot studies were also reviewed; a combined cognitive behavioral and psycho-educational treatment approach [37] and a preliminary model for improving selfawareness among children in a group based pilot study [38] . Family/Caregiver: Twelve studies met criteria for the family, caregiver, and teacher intervention subdomain: 11 Class I and 1 Class II.…”

“…Catroppe, C and Muscara, F [37] 2009 3 Y III Chan, D [33] 2011 32 Y II Karver, C, et al [31] 2014 132 Y I Kesler, S. [35] 2011 23 Y III Krasny-Pacini, A. , et al [34] 2014 5 Y III Krasny-Pacini, A., et al [38] 2015 5 Y III Kurowski, B., et. al.…”

Searching for effective components of cognitive rehabilitation for children and adolescents with acquired brain injury: A systematic review

“…This model also emphasizes the importance of developmental stage a patient is in. For example, metacognitive trainings may not always be appropriate for young children, since they may not have developed sufficient self-awareness yet to successfully implement the strategies (64). Certain interventions may thus be less effective for children compared to adolescent.…”