Measuring domain-specific deficits in self-awareness in children and adolescents with acquired brain injury: Component analysis of the Paediatric Awareness Questionnaire

Abstract

Self-awareness has been found to vary across different functional domains for adults with acquired brain injury (ABI); however, domain-specific self-awareness is yet to be investigated following paediatric ABI. This study aimed to validate the Paediatric Awareness Questionnaire (PAQ) as a multi-domain measure of self-awareness and to investigate domain-specific self-awareness in children with ABI. One hundred and ninety-seven children and adolescents (8-16 years, M = 12.44, SD = 2.62) with mixed causes of ABI (70% with traumatic brain injury) and their parents (n = 197) were recruited through consecutive rehabilitation appointments and completed the PAQ. The 37 items of the parent version of the PAQ were subjected to a principal component analysis with varimax rotation. A fivecomponent solution (29 items) explained 64% of the variance in the PAQ items. Components revealed five domains of self-awareness: socio-emotional functioning, activities of daily living (ADLs), cognition, physical functioning, and communication. Internal consistency of the components ranged from acceptable to excellent (α = .70-.95). The analysis identified that children had poorer self-awareness of cognitive functioning than socio-emotional functioning, ADLs, and communication skills. Overall, the findings identify five components (i.e., functional domains) of self-awareness and provide some support that self-awareness varies across domains following paediatric ABI.

Cognitive rehabilitation in paediatric acquired brain injury—A 2-year follow-up of a randomised controlled trial

“…Another reason why pGMT did not outperform pBHW may be the potential effect of parent/child perception and expectations. It is well recognised that children with pABI have difficulties engaging in self-reflective processes and tend to overestimate their own abilities and are not aware of their actual level of functioning ( 56 , 57 ). It is possible that the inherent difficulties in self-reflection that affect children with pABI limit the benefit of pGMT as this treatment requires metacognitive resources beyond the abilities of the patient group and thereby voids the increase in potential benefit therefrom.…”