Master of Arts (MA)
First Committee Member
Number of Pages
Traumatic brain injuries (TBI) occur quite frequently in children and adolescents. One difficulty in understanding and treating TBI lies in the heterogeneous nature of its acquisition and mechanism of injury, and the resulting neurocognitive impairment. While there are instruments that exist to identify such impairment, they typically are divided into very broad domains of academic performance. Tests such as the Wechsler Intelligence Scale for Children (WISC) and the Woodcock Johnson are helpful in identifying impairment within the realm of academic aptitude, but have thus far not provided specific enough information as to the impairment of the underlying neurocognitive process that may be causing the degraded performance. In recent years, however, there has been an increase in tests specifically to assess neurocognitive functioning in children. One such test, the Test of Memory and Learning (Reynolds & Bigler, 1994), includes both nonverbal and verbal components, similar to the WISC, as well as indices of performance that measure broader underlying neurocognitive processes such as memory, learning, and attention/concentration factors. The purpose of the current study was to investigate the heterogeneity in neurocognitive function demonstrated by children who have sustained a TBI. Understanding the profiles of neurocognitive impairment that occur in child TBI may assist in predicting outcomes and treatment planning. From a theoretical perspective, patterns of performance on neuropsychological tests may provide unique insights into the type of injury sustained and the brain structures that are most susceptible to injury. In the present investigation, heterogeneity in neurocognitive function was investigated using cluster analysis of neuropsychological domains assessed by the Test of Memory and Learning (TOMAL). A five-cluster solution for the TOMAL, data was selected as the optimal cluster solution. It best exhibited differences in level and pattern of performance, as well as differences on important clinical and behavioral variables. Empirical support for the identification of clusters based upon TOMAL scores, Intelligence scores (IQ) and behaviors reported on the Behavior Assessment System for Children (BASC) further supported the selected cluster solution, and should assist clinicians in providing both a more informed prognosis and a more prescriptive treatment intervention.
Brain; Heterogeneity; Injury; Neurocognitive; Parsing; Pediatric; Traumatic
Clinical psychology; Cognitive psychology; Developmental psychology
University of Nevada, Las Vegas
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Leany, Brian D, "Parsing neurocognitive heterogeneity in pediatric traumatic brain injury" (2007). UNLV Retrospective Theses & Dissertations. 2246.