Online problem-solving therapy for executive dysfunction after child traumatic brain injury

Brad G. Kurowski, Shari L. Wade, Michael W. Kirkwood, Tanya M. Brown, Terry Stancin, H. Gerry Taylor

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

OBJECTIVE: Executive dysfunction after traumatic brain injury (TBI) in children is common and leads to significant problems in functioning across multiple settings. The objective of this study was to evaluate the efficacy of a web-based counselor-assisted problem solving (CAPS) intervention compared with an Internet resource comparison (IRC) for treatment of executive dysfunction within 12 months after complicated mild to severe TBI in adolescents. We hypothesized that CAPS would significantly improve parent ratings of executive dysfunction compared with an IRC. METHODS: Participants included 132 adolescents aged 12 to 17 years who sustained a complicated mild to severe TBI within 1 to 6 months before study enrollment. Study design was a multisite, assessorblinded, randomized controlled trial. Study sites included 3 tertiary pediatric hospitals and 2 tertiary general medical centers. The main outcome measure was primary caregiver Behavioral Rating Inventory of Executive Function Global Executive Composite at baseline and 6-month follow-up. Generalized linear models that controlled for baseline scores were used to compare the CAPS and IRC scores. RESULTS: In older teens, the CAPS group showed significant improvement in executive function behaviors at 6-month follow-up compared with the IRC group (F = 6.74, P = .01, Cohen's d = 0.63). CONCLUSIONS: Findings indicate that web-based CAPS improves primary caregiver-rated executive functioning within the first 12 months after TBI in older adolescents. Future research needs to define the optimal timing after injury for delivery of CAPS and characteristics of individuals and families who are most likely to benefit from CAPS. Pediatrics 2013;132:e158-e166.

Original languageEnglish (US)
JournalPediatrics
Volume132
Issue number1
DOIs
StatePublished - Jul 1 2013

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Internet
Executive Function
Therapeutics
Caregivers
Pediatric Hospitals
Traumatic Brain Injury
Counselors
Problem Solving
Therapy
Tertiary Care Centers
World Wide Web
Linear Models
Randomized Controlled Trials
Outcome Assessment (Health Care)
Pediatrics
Equipment and Supplies
Resources
Wounds and Injuries
Rating

Keywords

  • Adolescent
  • Brain injury
  • Child
  • Executive function
  • Online
  • Therapy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Arts and Humanities (miscellaneous)

Cite this

Kurowski, B. G., Wade, S. L., Kirkwood, M. W., Brown, T. M., Stancin, T., & Taylor, H. G. (2013). Online problem-solving therapy for executive dysfunction after child traumatic brain injury. Pediatrics, 132(1). https://doi.org/10.1542/peds.2012-4040

Online problem-solving therapy for executive dysfunction after child traumatic brain injury. / Kurowski, Brad G.; Wade, Shari L.; Kirkwood, Michael W.; Brown, Tanya M.; Stancin, Terry; Taylor, H. Gerry.

In: Pediatrics, Vol. 132, No. 1, 01.07.2013.

Research output: Contribution to journalArticle

Kurowski, BG, Wade, SL, Kirkwood, MW, Brown, TM, Stancin, T & Taylor, HG 2013, 'Online problem-solving therapy for executive dysfunction after child traumatic brain injury', Pediatrics, vol. 132, no. 1. https://doi.org/10.1542/peds.2012-4040
Kurowski, Brad G. ; Wade, Shari L. ; Kirkwood, Michael W. ; Brown, Tanya M. ; Stancin, Terry ; Taylor, H. Gerry. / Online problem-solving therapy for executive dysfunction after child traumatic brain injury. In: Pediatrics. 2013 ; Vol. 132, No. 1.
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