A-064 Executive Functioning in an Acute Pediatric Neurocritical Care Population Recently Discharged from the PICU: Exploring the Associations among Parent Report and Individual Performance Measures

Abstract

Abstract Objective An emerging literature has identified that PICU survivors face a host of long-term physical, cognitive, emotional, and psychosocial difficulties that stem from the underlying concern and side effects of critical care intervention. Research shows that executive functioning (EF) is particularly vulnerable to sequelae. This study sought to understand associations between parent-report of daily life EF and performance-based measures following neurocritical care. Method Twenty-three children ages 8–16 (M = 12.66 years; 39% male) were screened as part of an integrated (neuropsychology and pediatric critical care) acute phase (3–6-week post-discharge) follow-up clinic. Injuries included children with traumatic brain injury (n = 19), or acquired brain injury (i.e., anoxic brain injury, AVM, acute cerebellitis, hemorrhagic stroke; n = 4). EF outcomes were assessed using the Behavior Rating Inventory of Executive Functioning, Second Edition (BRIEF-2), Delis-Kaplan Executive Function System (D-KEFS) Trail Making Test and Verbal Fluency Test, Children’s Memory Scale Digits Backwards, and Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V) Coding and Symbol Search subtests. Bivariate correlations were used to examine associations among parent-report of EF and performance-based measures of EF in our neurocritical care population. Results Analyses demonstrated significant (□ = .05) correlations between the WISC-V Coding subtest and the BRIEF-2 Shift scale (r = −.44) and Global Executive Composite (GEC; r = −.59). Correlations between D-KEFS Category Fluency and BRIEF-2 Initiate (r = −.51), Working Memory (r = −.44), and GEC (r = −.55) were significant. Inverse correlations demonstrate agreement. Conclusion In the acute recovery phase following neurocritical care, parent-report and specific performance-based measures are only moderately associated, demonstrating the importance of multi-method assessment to detect potential acquired deficits to inform rehabilitation.