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Concept formation and problem-solving following closed head injury in children

Published online by Cambridge University Press:  01 November 1997

HARVEY S. LEVIN
Affiliation:
Cognitive Neuroscience Laboratory, Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX
JAMES SONG
Affiliation:
Cognitive Neuroscience Laboratory, Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX
RANDALL S. SCHEIBEL
Affiliation:
Cognitive Neuroscience Laboratory, Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX
JACK M. FLETCHER
Affiliation:
Department of Pediatrics, University of Texas Medical School, Houston, TX
HARRIET HARWARD
Affiliation:
Callier Center for Communication Disorders, University of Texas at Dallas, Dallas, TX
MATT LILLY
Affiliation:
Private consultant, Baltimore, MD
FELICIA GOLDSTEIN
Affiliation:
Department of Neurology, Emory University, Atlanta, GA

Abstract

To further investigate the usefulness of 3 purported measures of executive function (EF) in head injured children, we administered the Twenty Questions Test (TQT), Tower of London (TOL), and the Wisconsin Card Sorting Test (WCST) to 151 children who had sustained a closed head injury (CHI) of varying severity about 3 years earlier. In addition, we tested 89 normal controls. Fifty-seven of the patients were included in a longitudinal study that compared performance at 3 months and 36 months. All of the head injured children underwent magnetic resonance imaging for investigational purposes. Severity of CHI, as defined by the lowest Glasgow Coma Scale (GCS) score, affected performance on all 3 EF measures. Focal lesion volume incremented prediction of performance on TOL and WCST, but not TQT. Moderate intercorrelations of the test variables were obtained. Although all three EF measures depicted changes in performance over 3 years, a ceiling effect detracted from the sensitivity of the TOL to the impact of CHI on development. Implications of the findings for clinical applications are discussed. (JINS, 1997, 3, 598–607.)

Type
Research Article
Copyright
© 1997 The International Neuropsychological Society

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