Reliability and Validity of a Virtual Reality-based Cognitive Assessment Tool (VR-CAT) for Children with TBI

Abstract

<h3>Research Objectives</h3> An estimated 700,000 pediatric traumatic brain injury (TBI) cases are reported each year in the U.S. The long-term goal of this project is to address the need to identify and treat those patients with persistent executive function problems. Virtual reality (VR) has the potential to provide an immersive environment for measuring EFs. This presentation aimed to examine the reliability and validity of the VR-based Cognitive Assessment Tool (VR-CAT) for inhibitory control [IC], working memory [WM], cognitive flexibility [CF]). <h3>Design</h3> Cross-sectional design with comparison. <h3>Setting</h3> Level 1 trauma center. <h3>Participants</h3> A total of 24 patients 7-17 years with mild complicated/moderate/severe TBI and 30 patients with orthopedic injury (OI) participated. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> Test-retest reliability was measured by correlating VR scores between two assessments among TBI/OI patients. Concurrent validity, ecological validity, and diagnostic validity was measured among TBI and OI patients using NIH Toolbox Cognitive Battery and BRIEF2. <h3>Results</h3> VR-CAT demonstrated adequate test-retest reliability on IC, WM, and CF. Adequate concurrent validity on IC and WM but not CF tasks was established by significant correlation with respective age-corrected NIH Toolbox scores. VR-CAT demonstrated adequate ecological validity with BRIEF2 only on WM but not IC or CF. Finally, VR-based WM (but not IC or CF) task showed fair diagnostic validity between TBI and OI groups. <h3>Conclusions</h3> VR-CAT demonstrated high temporal reliability inhibitory control, working memory, and cognitive flexibility. It also showed adequate concurrent, ecological, and diagnostic validity on working memory. <h3>Author(s) Disclosures</h3> None.