Measuring executive dysfunction in an acute rehabilitation setting: Using the dysexecutive questionnaire (DEX)

2005 ◽  
Vol 11 (4) ◽  
pp. 376-385 ◽  
Author(s):  
PAULEEN C. BENNETT ◽  
BEN ONG ◽  
JENNIE PONSFORD
Keyword(s):  
Traumatic Brain Injury ◽  
Rating Scales ◽  
Behavioral Assessment ◽  
Executive Dysfunction ◽  
Accurate Information ◽  
Neuropsychological Measures ◽  
Sensitivity And Selectivity ◽  
Executive Deficits ◽  
Behavioral Rating Scales ◽  
Acute Rehabilitation

It is recognized that existing neuropsychological measures of executive dysfunction lack adequate sensitivity and selectivity. While attempts have been made to develop improved measures, these have not yet been of great value to those who need to accurately identify executive deficits in a clinical setting. Several behavioral rating scales have been developed for this reason, including the 20-item Dysexecutive Questionnaire (DEX), which forms part of the Behavioral Assessment of the Dysexecutive Syndrome (BADS) test battery. To investigate the ability of the DEX to identify executive dysfunction in an acute rehabilitation setting, the BADS was administered to 64 persons who had sustained traumatic brain injury. It was found to be almost as sensitive to executive dysfunction, as measured by the total score obtained on the BADS battery, as an extended 65-item version of the scale, when completed by either the occupational therapist or clinical neuropsychologist working with each patient. Family members and the patient themselves provided, as expected, less accurate information. Our results indicate that the DEX can be used with some confidence as a screening instrument to identify executive dysfunction in an acute rehabilitation setting, provided it is completed by professional personnel, trained to be sensitive to the cognitive and behavioral concomitants of this disorder. (JINS, 2005,11, 376–385.)

scholarly journals Pragmatic and executive functions in traumatic brain injury and right brain damage: An exploratory comparative study

2011 ◽  
Vol 5 (4) ◽  
pp. 337-345 ◽  
Author(s):  
Nicolle Zimmermann ◽  
Gigiane Gindri ◽  
Camila Rosa de Oliveira ◽  
Rochele Paz Fonseca
Keyword(s):  
Traumatic Brain Injury ◽  
Working Memory ◽  
Brain Injury ◽  
Executive Functions ◽  
Descriptive Analysis ◽  
Executive Dysfunction ◽  
Wisconsin Card Sorting Test ◽  
Card Sorting ◽  
Right Brain ◽  
Executive Deficits

Abstract Objective: To describe the frequency of pragmatic and executive deficits in right brain damaged (RBD) and in traumatic brain injury (TBI) patients, and to verify possible dissociations between pragmatic and executive functions in these two groups. Methods: The sample comprised 7 cases of TBI and 7 cases of RBD. All participants were assessed by means of tasks from the Montreal Communication Evaluation Battery and executive functions tests including the Trail Making Test, Hayling Test, Wisconsin Card Sorting Test, semantic and phonemic verbal fluency tasks, and working memory tasks from the Brazilian Brief Neuropsychological Assessment Battery NEUPSILIN. Z-score was calculated and a descriptive analysis of frequency of deficits (Z< -1.5) was carried out. Results: RBD patients presented with deficits predominantly on conversational and narrative discursive tasks, while TBI patients showed a wider spread pattern of pragmatic deficits. Regarding EF, RBD deficits included predominantly working memory and verbal initiation impairment. On the other hand, TBI individuals again exhibited a general profile of executive dysfunction, affecting mainly working memory, initiation, inhibition, planning and switching. Pragmatic and executive deficits were generally associated upon comparisons of RBD patients and TBI cases, except for two simple dissociations: two post-TBI cases showed executive deficits in the absence of pragmatic deficits. Discussion: Pragmatic and executive deficits can be very frequent following TBI or vascular RBD. There seems to be an association between these abilities, indicating that although they can co-occur, a cause-consequence relationship cannot be the only hypothesis.

The effect of phototherapy on sleep during acute rehabilitation after traumatic brain injury: a randomized controlled trial

Brain Injury ◽  
2021 ◽  
pp. 1-9
Author(s):  
Kathleen R. Bell ◽  
Donald Fogelberg ◽  
Jason Barber ◽  
Risa Nakase-Richardson ◽  
Jennifer M. Zumsteg ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Randomized Controlled Trial ◽  
Brain Injury ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Acute Rehabilitation

The Use of Rating Scales With Children Who Have Language Impairments

2002 ◽  
Vol 11 (2) ◽  
pp. 124-138 ◽  
Author(s):  
Sean M. Redmond
Keyword(s):  
Special Education ◽  
Emotional Disorders ◽  
Rating Scales ◽  
Language Impairments ◽  
Special Education Services ◽  
Speech Language Pathologists ◽  
Language Bias ◽  
Education Services ◽  
Behavioral Rating ◽  
Behavioral Rating Scales

Several reports suggest that socio-emotional disorders and language impairments frequently co-occur in children receiving special education services. One explanation for the high levels of co-occurrence is that limitations inherent to linguistic deficiencies are frequently misinterpreted as symptomatic of underlying socioemotional pathology. In this report, five commonly used behavioral rating scales are examined in light of language bias. Results of the review indicated that children with language impairments are likely to be overidentified as having socioemotional disorders. An implication of these findings is that speech-language pathologists need to increase their involvement in socioemotional evaluations to ensure that children with language impairments as a group are not unduly penalized for their language limitations. Specific guidelines for using ratings with children with language impairments are provided.

scholarly journals Neuropsychological Performance of Youth with Secondary Attention-Deficit/Hyperactivity Disorder 6- and 12-Months after Traumatic Brain Injury

2014 ◽  
Vol 20 (10) ◽  
pp. 971-981 ◽  
Author(s):  
Tisha J. Ornstein ◽  
Sanya Sagar ◽  
Russell J. Schachar ◽  
Linda Ewing-Cobbs ◽  
Sandra B. Chapman ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Attention Deficit Hyperactivity Disorder ◽  
Brain Injury ◽  
Executive Control ◽  
Attention Deficit ◽  
Executive Dysfunction ◽  
Control Measures ◽  
Post Injury ◽  
Psychiatric Interview ◽  
Hyperactivity Disorder

AbstractThe present study compared executive dysfunction among children with attention-deficit/hyperactivity disorder (ADHD) after traumatic brain injury (TBI), also called secondary ADHD (S-ADHD), pre-injury ADHD and children with TBI only (i.e., no ADHD). Youth aged 6–16 years admitted for TBI to five trauma centers were enrolled (n=177) and evaluated with a semi-structured psychiatric interview scheduled on three occasions (within 2 weeks of TBI, i.e., baseline assessment for pre-injury status; 6-months and 12-months post-TBI). This permitted the determination of 6- and 12-month post-injury classifications of membership in three mutually exclusive groups (S-ADHD; pre-injury ADHD; TBI-only). Several executive control measures were administered. Unremitted S-ADHD was present in 17/141 (12%) children at the 6-month assessment, and in 14/125 (11%) children at 12-months post-injury. The study found that children with S-ADHD exhibited deficient working memory, attention, and psychomotor speed as compared to children with pre-injury ADHD. Furthermore, the children with S-ADHD and the children with TBI-only were impaired compared to the children with pre-injury ADHD with regard to planning. No group differences related to response inhibition emerged. Age, but not injury severity, gender, or adaptive functioning was related to executive function outcome. Neuropsychological sequelae distinguish among children who develop S-ADHD following TBI and those with TBI only. Moreover, there appears to be a different pattern of executive control performance in those who develop S-ADHD than in children with pre-injury ADHD suggesting that differences exist in the underlying neural mechanisms that define each disorder, underscoring the need to identify targeted treatment interventions. (JINS, 2014,20, 971–981)

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