Emerging research supports the contribution of executive function (EF) to reading comprehension; however, a unique pattern has not been established for children who demonstrate comprehension difficulties despite average word recognition ability (specific reading comprehension deficit; S-RCD). To identify particular EF components on which children with S-RCD struggle, a range of EF skills was compared among 86 children, ages 10 to 14, grouped by word reading and comprehension abilities: 24 average readers, 44 with word recognition deficits (WRD), and 18 S-RCD. An exploratory principal components analysis of EF tests identified three latent factors, used in subsequent group comparisons: Planning/Spatial Working Memory, Verbal Working Memory, and Response Inhibition. The WRD group exhibited deficits (relative to controls) on Verbal Working Memory and Inhibition factors; S-RCD children performed more poorly than controls on the Planning factor. Further analyses suggested the WRD group's poor performance on EF factors was a byproduct of core deficits linked to WRD (after controlling for phonological processing, this group no longer showed EF deficits). In contrast, the S-RCD group's poor performance on the planning component remained significant after controlling for phonological processing. Findings suggest reading comprehension difficulties are linked to executive dysfunction; in particular, poor strategic planning/organizing may lead to reading comprehension problems.
Cognitive deficits are frequent consequences of acquired brain injury (ABI) and often require intervention. We review the theoretical and empirical literature on cognitive rehabilitation in a variety of treatment domains including attention, memory, unilateral neglect, speech and language, executive functioning, and family involvement/education. Because there are more well-designed studies examining the efficacy of cognitive rehabilitation in adults with brain injury, the major findings from this body of literature are also highlighted. In addition, given that similar cognitive and behavioral concerns are often apparent in children with certain neurodevelopmental disorders, selected literature focusing on interventions for these groups of children is included. Limitations and challenges inherent in examining cognitive interventions in children with ABI are also discussed. Overall, despite the growing body of literature examining the efficacy of cognitive rehabilitation in children with ABI, there continues to be a great need to develop well-designed studies to examine the efficacy of these interventions.
This paper updates guidelines of effective treatments for children with acquired brain injury (ABI) by including new evidence found in recent years and by building upon evidence presented in 2007. A systematic search was conducted for articles published from 2006-2017. Full manuscripts describing treatments of children (post-birth to 18) with acquired brain injury were included if study was published in peer-reviewed journals and written in English. Two independent reviewers and a third, if conflicts existed, evaluated the methodological quality of studies with an Individual Study Review Form and a Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Strength of study characteristics was used in development of practice guidelines. Fifty-six peer-reviewed articles, including 28 Class I studies, were included in the final analysis. Established guidelines for writing practice recommendations were used and 22 practice recommendations were written with details of potential treatment limitations. There was strong evidence for family/caregiver-focused interventions, as well as direct interventions to improve attention, memory, executive functioning, and emotional/behavioral functioning. A majority of the practice standards and guidelines provided evidence for the use of technology in delivery of interventions, representing an important trend in the field.
Highlights
Neurology teams can care for patients with COVID-19 in lieu of being redeployed.
Maintaining team structures has advantages to redeployment during pandemic surges.
Streamlining neurological services increases capacity to care for COVID-19 patients.
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