Affective Domain Research Articles

Unveiling the Impact of Moderate and Severe Atopic Dermatitis: Insights on Burden, Clinical Characteristics, and Healthcare Resource Utilization in Adult Greek Patients from the APOLO Cross-Sectional Study

Background: Moderate to severe (M2S) atopic dermatitis (AD) is a chronic condition impacting individuals, society, and healthcare systems. Considering the changing M2S-AD treatment landscape, this study assesses the M2S-AD burden in patients reaching referral centers in Greece. Methods: This was a multicenter, cross-sectional study. Patients aged 12 years or older with clinically diagnosed M2S-AD were enrolled. Data collected included clinical practice assessments and the following validated patient-reported instruments: Dermatology Life Quality Index (DLQI); EuroQol-5 Dimensions-3 Level scale (EQ-5D-3L); Patient Oriented Eczema Measure (POEM); Peak Pruritus Numerical Rating Scale (PP-NRS); and Work Productivity and Activity Impairment: General Health (WPAI:GH). A pain frequency/intensity/cause questionnaire and a sleep disturbance scale were also used. Results: Outcomes of 184 adults (51.1% female) with M2S-AD based on the Eczema Area and Severity Index (EASI) are presented (n = 117 moderate; n = 67 severe). Among the patients, 14.8% were obese, 59.2% had allergic comorbidities, and 88.0% were receiving AD-specific therapy (systemic: 38.6%). The median age, disease duration, body surface area, and total EASI scores were 38.8 years, 11.8 years, 30.0%, and 16.9, respectively. The median DLQI score was 12.0, with ‘symptoms/feelings’ being the most affected domain. EQ-5D dimensions ‘anxiety/depression’ and ‘pain/discomfort’ were also affected (65.2% and 64.1% reporting problems, respectively). The median POEM score was 17.0. Pain, severe pruritus (PP-NRS ≥ 7), and sleep disturbance were reported by 80.4%, 62.0%, and 88.5%, respectively. The median WPAI:GH ‘work productivity loss’ and ‘activity impairment’ scores were 23.8% and 30.0%, respectively. Conclusions: Both moderate and severe AD patients reaching Greek specialized centers experience significant symptom burden and impairments in quality of life, sleep, work, and daily activities.

Learning medical sociology through an innovative 'Elective study module' integrating humanities with medicine for undergraduate students of a medical college in Bengaluru, India.

Background The newly introduced 'Elective programme', a voluntary special study module in the final phase of the undergraduate medical curriculum, offers scope for new immersive, self-directed learning opportunities. We describe a programme of study for learning 'medical sociology' through the innovative use of humanities in medicine. Methods Our elective module, called 'Community Health and Rock Music' (CHaRM), was a 2-week programme, merging the curricular subject of community health with 'rock music' as an exposure to the 'counter-culture' outside of the medical world. The half-day sessions consisted of: (i) watching/listening to a rock song-video without reading its lyrics; (ii) listening to the same song again but with lyrics; (iii) undertaking an emotionally stimulating activity (watching a movie, making a site-visit, etc.); and (iv) debriefing, to identify/discuss the underlying social determinants of health and their relevance in the grooming of a socially aware medical student. Formative assessment was intended to gauge levels of expression of the affective domain (attitude/emotions). Results Seven of 143 students volunteered for this programme. Key learnings were a clear appreciation of the societal determinants of health (such as deprivation/discrimination/social structures); multi-level causation of diseases; social issues not addressed in traditional medical curriculum; personal growth; teamwork; and the role of empathy in medical practice. Additional learning was the exposure to the 'counter-culture of arts'. All 7 student assessments 'met expectation', with 4 of them 'exceeding expectation'. Conclusion An 'elective programme' combining humanities with medicine is potentially an innovative, student-centric and replicable model of learning that impacts the affective domain critical for doctors-in-training.

INCREASING STUDENTS’ EMPATHY LEVELS IN SCIENCE EDUCATION: A THEMATIC REVIEW

K-12 education as an enterprise always has two main aims; to teach basic skills and knowledge and to cultivate moral citizenry. There is substantial evidence that empathy can promote morality and character development through education. To shed light on what has been done and to identify the pathways already established, a thematic review of research focused on empathy development in K-12 science education has been conducted. A systematic examination of literature published before January 2024 resulted in 28 publications being analyzed in terms of their general characteristics and the specifics of the designed interventions. Results show that educational interventions can improve empathy skills; these studies use collaborative learning environments, take 3-10 weeks to implement, and the most preferred strategy is recognizing different perspectives of a given situation with reflective exercises. All of the studies reviewed positively affected students' affective and cognitive domains. For future research, more interventions designed to improve empathy skills in parallel with the science curriculum are proposed to supply teachers with new comprehensive resources to implement. Keywords: empathy development, empathy skills, science education, thematic review

I see you: teacher analytics with GPT-4 vision-powered observational assessment

This preliminary study explores how GPT-4 Vision (GPT-4V) technology can be integrated into teacher analytics through observational assessment, aiming to improve reflective teaching practice. Our study develops a Video-based Automatic Assessment System (VidAAS) powered by GPT-4V. This approach uses Generative Artificial Intelligence (GenAI) to provide detailed insights into classroom dynamics. Our study encompasses various methods with multiple steps: a comprehensive literature review, prototype development of the VidAAS, and usability testing with in-service teachers. The study findings reveal that VidAAS demonstrates high accuracy in evaluating skills in the behavioral (psychomotor) domain and offers comprehensive explanations for each assessment. While showing promise in these areas, the system also indicates potential for further enhancement in processing speed and refinement in assessing cognitive and affective domains. We discuss how VidAAS supports teachers’ reflection-in-action and reflection-on-action, emphasizing the need to balance AI-driven insights and human judgment. Our study findings also guide future research avenues for VidAAS design, implementation, and integration in teacher analytics, underscoring GPT-4V’s potential for real-time, scalable feedback and a deeper classroom understanding.

A quasi-experimental study of trigger films for teaching the doctor-patient relationship

Background: It is challenging to teach the complexity of the doctor-patient relationship through attitude, ethics, and communication (AETCOM) modules, particularly without being formally trained and especially to first-year medical students who do not interact directly with patients. The present study was undertaken to assess the effectiveness of trigger films (TFs) or short movie clips as a teaching-learning tool to train undergraduate medical students on various aspects of doctor-patient relationships. Methods: Two modules on various aspects of the doctor-patient relationship were developed using TFs and written case studies and implemented on Phase Ⅰ medical students. Quantitative and qualitative feedback were collected from learners. Perception, understanding, and knowledge were assessed using pre- and post-questionnaires. The results of the feedback and questionnaires collected after using TFs were compared with those collected after using written case studies. Results: There was a gain in knowledge and understanding after TF sessions, and TF sessions were rated much higher by the students than traditional methods. Most students found TFs to be an innovative and interesting tool. The satisfaction index calculated for TFs from the feedback of both students and teachers was above 96%. Conclusions: TFs engaged the students’ affective domain, promoted reflective attitudes, and linked their learning to experiences. It was reported not only to be interesting and engaging but also effective as a teaching tool.

Exploring learners’ attitudes towards meme consumption and their implications for classroom use

ABSTRACT This study tries to ascertain the attitudes of tertiary learners’ internet meme consumption and its potential for pedagogical implications. Internet memes, as multifaceted cultural artefacts, have become pervasive in contemporary digital communication, influencing societal discourse and online interactions. Despite their prevalence, research on learners’ everyday experiences and attitudes towards memes in educational settings is a rarity. This research therefore aims to examine the affective and cognitive attitudes of undergraduate students towards internet meme culture. Utilising a cross-sectional survey design, data was collected from 119 second-year undergraduate students at St. Joseph's College (Autonomous), Tiruchirappalli, India. The questionnaire focused on measuring both affective and cognitive appeal towards meme consumption. The analysis revealed that memes as an educational tool have a positive impact on the affective and cognitive domains in a classroom setting.

Meningkatan Hasil Belajar PAKBP Melalui Pembelajaran PBL pada Materi Aku Pribadi yang Unik Kelas IV SDS Dakwatul Islam

This research is conducted with the aim of improving the learning outcomes of students by using the Problem-Based Learning (PBL) model for the students in grade IV Phase B of SDS DAKWATUL ISLAM in the academic year 2023/2024." The learning outcomes referred to in this research include abilities in the cognitive, affective, and psychomotor domains. The type of research conducted is classroom action research (CAR)." The research design uses the Problem-Based Learning (PBL) model. The subjects of this study are the students in Grade IV Phase B of SDS DAKWATUL ISLAM, which consists of 7 students." The object of the research is the learning outcomes of the students. Data collection techniques utilize both test and non-test methods." The conclusion drawn from this research is that using the Problem-Based Learning (PBL) method can effectively support the learning process, enabling the learning objectives to be achieved successfully."

Exploring Sustainability Instruction Methods in Engineering Thermodynamics Courses: Insights from Scholarship of Teaching and Learning

It is important that engineers are educated to consider sustainability in their work. Thermodynamics is a fundamental course required in several engineering majors that has a natural connection to sustainability topics (e.g., energy and limits on efficiency). This work examined how sustainability was included in university-level engineering thermodynamics courses, based on 18 peer-reviewed papers that described Scholarship of Teaching and Learning studies. This review found that environmental issues were included in 15 courses, social issues in 9 courses, and economic issues in 5. There were 11 papers that included topics related to one or more of the United Nations’ Sustainable Development Goals (SDGs), with 8 of the 17 SDGs represented by one or more papers. The learning outcomes from the courses provided many examples of cognitive outcomes at all six levels of Bloom’s taxonomy. In contrast, affective domain outcomes were generally not explicit. Methods of integrating sustainability topics included mathematical examples, labs, projects, service-learning, application-based learning, simulation tools, and book reviews. These examples should inspire instructors to foster sociotechnical mindsets toward engineering, which are a key to educating engineers who value sustainability and who will advocate for its importance in engineering.

Early region-specific impact of adjuvant radiation therapy on cognition and quality of life in adult patients with primary brain tumors.

While treatments for primary brain tumors increase survival, they have cognitive sequelae. Neurocognition's anatomical distribution makes it susceptible to brain damage. This study aims to evaluate the contribution of radiotherapy on short-term cognitive impairment. Using a prospective database of cognitive rehabilitation in adults operated on for primary brain tumors, a retrospective sub-analysis of the contribution of radiotherapy was performed. Thirty-four subdivisions of 12 neurocognitive regions were delineated in 48 irradiated patients and 30 non-irradiated patients. In the first group, the correlation between radiation dose and deterioration was evaluated. In all patients, the impact of tumor and surgical changes on dysfunction was calculated and compared with dose-dependent response. The correlation between cognitive status and radiation dose is especially strong and significant in the left hemisphere and in specific subdivisions such as the posterior hippocampus or the dorsolateral prefrontal cortex, with the left prevailing over posterior dominance. Memory is the most affected domain 1month after radiotherapy, as attention is three months later. The hippocampus is involved in various cognitive domains in addition to memory. The prefrontal subregions and the genu of the corpus callosum are more affected by the relationship with disease and surgical changes than by radiation exposure. Patients ongoing a course of radiotherapy do not benefit from concurrent cognitive rehabilitation. There is a correlation between the dose of radiation received by several encephalic regions and degree of short-term domain-specific cognition decline, considering other factors of risk and cognitive rehabilitation.

The quality of life of primary caretakers of children with cerebral palsy

ABSTRACT Background: Cerebral palsy (CP) is a heterogeneous group of disorder affecting the development of movement and posture, which is permanent nonprogressive. Previous studies in different regions have shown links between caregivers’ mental health and children’s well-being. However, the lack of such detailed research for the caretakers of children with CP and correlation of quality of life affected the type and severity of the condition; this necessitates the development of a new study to assess caregivers’ quality of life. Aim: Quality of life among caregivers of disabled children is an important concern in healthcare. We aim to evaluate the quality of life among caregivers of children with CP and to assess the factors affecting the caregivers’ quality of life, namely, age, gender, type, and gross motor function in children with CP. Methodology: This was a cross-sectional observational study, conducted over a period of 6 months. It included the caregivers of children with CP at a tertiary care hospital of Mumbai. Data were collected using the WHO BREF questionnaire. The children were divided into two groups (2 to 7 years and 7 to 12 years). The qualities of life of the caretakers of these two groups were compared in four domains, namely, physical, psychological, social, and environmental. Results: The study included 50 participants. Mothers (80%) and fathers (10%) were the primary caregivers. Caretakers of the children with cerebral palsy showed significant affected quality of life as calculated from WHO QOL BREF score in both age groups (2–7 and 7–12 years) and in all domains. Overall, the most affected domain in our study was of psychological health and the least affected domain was of the environmental domain. Conclusion: This study provides a snapshot of the impact of having a child with cerebral palsy on the lives of the caregivers Most of the caregivers in the study were mothers, and quality of life was affected in all domains mainly in psychological and physical domains. The study showed that there is a need for interventions in caregivers which can have an indirect impact on the children with CP.

Effects of skin-to-skin contact on mental health outcomes in the parents of full-term newborns: A systematic review and meta-analysis of randomized clinical trials

BackgroundThe postpartum period can be emotionally challenging for parents, with documented levels of anxiety, stress, and depression. While the benefits of skin-to-skin contact (SSC) are well-known, its impact on the mental health of parents of full-term newborns has been less studied. Objective: We aimed to assess the effects of SSC in mental health outcomes in the parents of full-term newborns. MethodsIn this systematic review, a comprehensive search was conducted to identify randomized clinical trials (RCTs) comparing SSC versus no SSC and assessing mental health outcomes. Meta-analyses were performed whenever possible, and the GRADE approach was used to rate the certainty of evidence. ResultsWe included 9 RCTs with 1201 participants. Regarding the risk of bias, the most affected domains were selective reporting, blinding, and allocation concealment. Regarding parental anxiety, SSC may reduce it at short-term, while it is unsure its effect at mid-term and it may not have any effect at long-term. Regarding Psychological stress, SSC may not have an impact at mid- and long-term. Regarding delivery-related post-traumatic stress symptoms, SSC may not have an impact at short-, mid-, and long-term. Regarding depressive symptoms, the evidence is uncertain at short- and mid-term. LimitationsFor the assessed outcomes, certainty of the evidence was low or very low. ConclusionSSC may reduce parental anxiety at short-term, while it may not have an impact in psychological stress and delivery-related post-traumatic stress symptoms. Moreover, the evidence is uncertain regarding its effect in long-term anxiety and depressive symptoms.

Comparing self-other distinction across motor, cognitive and affective domains.

The self-other distinction (SOD) is a process by which humans disentangle self from other-related mental representations. This online study investigated two unresolved questions: (i) whether partially the same processes underpin SOD for motor, cognitive and affective representations, and (ii) whether SOD overlaps with domain-general cognitive control processes. Participants (N = 243) performed three SOD tasks (motor: automatic imitation inhibition (AIT); cognitive: visual perspective-taking (VPT); affective: emotional egocentricity bias (av-EEB) tasks) and two cognitive control tasks (Stroop and stop-signal reaction time (SSRT) tasks). Correlation analyses showed no associations among the motor, cognitive and affective SOD indexes. Similarly, distinct SOD clusters emerged in the hierarchical clustering dendrogram, indicating clear separations among SODs. However, the results of multidimensional scaling suggested a tendency towards two clusters, as evidenced by the proximity of AIT and VPT indexes in relation to EEB indexes. AIT spatial laterality and Stroop domain-general cognitive control confounded AIT and VPT indexes, albeit slightly differently depending on the analysis method used. SSRT showed neither associations with SODs nor with other domain-general indexes. These findings underscore the complexity of SOD processes and have notable implications for basic and applied research, e.g. in the domain of clinical disorders affected by deficiencies in SOD.

Improving Learning Outcomes of Students of Class VII A Social Studies Subjects Through Mind Mapping Media.

The minimal use of media in learning activities can cause student learning outcomes to decline. This is because learning tends to use the lecture method, assignments depend on textbooks, are less interesting and learning feels boring. As a result, students become inactive and reluctant to listen to explanations of the material presented by the teacher, so that students do not understand the material being studied. This research method uses Classroom Action Research (PTK), earch cycle consists of four stages, namely the planning stage, action implementation, observation and reflection. Data collection techniques include observation, tests, questionnaires, documentation, interviews, teacher observation sheets and student activity observation sheets. Based on research, it shows that mind mapping learning media can improve student learning outcomes. In cycle I the cognitive domain reached a percentage of 63.23 (poor category), the affective domain reached a percentage of 62.66 (good category) and the psychomotor domain reached a percentage 35.5 (very poor category) then in cycle II there was an increase, namely in the cognitive domain the percentage 78.43 (very good category), affective domain of 82 (very good category) and psychomotor domain 84.5 (very good category). Thus, it can be concluded that mind mapping learning media can improve the learning outcomes of class VII A students in social studies at SMP Negeri 8 Pamekasan.

Predictors of Media Emotion Regulation and Its Consequences for Children’s Socioemotional Development

Media emotion regulation has been defined as parents’ use of media to regulate their children's emotions in early childhood. The purpose of this review is to investigate the predictors of media emotion regulation and its consequences on children's socioemotional development. As predictors of media emotion regulation, parental education level, parental media use, and the child’s temperament were examined. It was observed that parents with low levels of education and higher personal media use more frequently offer their children media emotion regulation than other parents. The relationships between children’s temperamental domains of negative affect and extraversion/surgency and media emotion regulation have been shown as positive, while the relationship between effortful control and media emotion regulation has been displayed as negative. As for the consequences of media emotion regulation on children's socioemotional development, children’s problematic media use, emotional knowledge, and empathy were examined. The relationship between media emotion regulation and problematic media use was displayed as positive; children who frequently experienced media emotion regulation had increased problematic media use. Also, it was shown that media emotion regulation has a negative role in children's emotional knowledge. As children's experience with media emotion regulation increased, their emotional knowledge decreased. Lastly, in the relationship between media emotion regulation and empathy, both positive and negative findings were observed and variables that may influence this relationship were discussed. This study contributes significantly to understanding the conditions under which children more frequently experience media emotion regulation and the role of this experience on children's socioemotional developmentAs the consequences of media emotion regulation on children’s socio-emotional development, children's problematic media use, emotional knowledge, and empathy have been explored. There is a positive relationship between media emotion regulation and problematic media use. As media emotion regulation increases, children's emotional knowledge decreases. Finally, in the relationship between media emotion regulation and empathy, both positive and negative outcomes have been found, suggesting that media content and how children perceive media emotion regulation may influence this relationship. This study offers a significant contribution by exploring the conditions under which children more frequently experience media emotion regulation and its role in children's socio-emotional development.

Multivariate analysis on students' cognitive assessment, attitude, and skill evaluation in problem-based learning

To improve the quality of education, the Ministry of Education and Culture of the Republic of Indonesia designed the "Merdeka" curriculum. With this curriculum, there are three learning outcomes, namely cognitive (knowledge), affective (character or attitude), and psychomotor (skills) domains. The learning that can be applied to the "MERDEKA" curriculum is the problem-based learning model. The significance of a variable in the learning process is very important to research to evaluate the learning process, especially in problem-based learning. Thus, the research objective of this study is to provide evidence of the significance of students’ cognitive assessment, attitude, and skill evaluation in mathematics learning. This study is a quantitative research using two-way multivariable analysis of variance (MANOVA), to determine the significance of cognitive assessment (assessment of learning outcomes), character or attitude, and skills evaluation in three classes of VIII students using problem-based learning (PBL). A two-way MANOVA analysis was carried out with students' class and gender factors, using measurement variables: cognitive assessment, attitude, and skill evaluation. From the results of the analysis, it was found that problem-based learning can be applied to Mathematics classes because, with this learning, both male and female students, the student's cognitive assessment is equally good in the significance level 5%. The differences in attitude and skill evaluation occurred because of the uniqueness of male and female students.

Enhancing Pedagogical Competence : Evaluating Islamic Religious Education Practices in West Aceh

The research aims to explore teachers' pedagogical competence in implementing evaluations of Islamic religious education, preparation for evaluations, use of information technology in implementing evaluations, implementation of comprehensive evaluations, and implementation of differentiated evaluations. Data collection methods included observations, interviews, and documentation. The selection of respondents employed purposive sampling to ensure data accuracy by directly sourcing primary information. Respondents consisted of school principals, school operators, and Islamic education teachers from high schools in the Aceh Barat region. Six tests were utilized to ensure data credibility: extension of observation time, triangulation, member checking, independent analysis, theoretical validity, and negative case analysis. Data analysis followed the Miles and Huberman model, encompassing data reduction, data display, and conclusion drawing or verification. The research results show that teachers' pedagogical competence in implementing Islamic religious education evaluations is quite good, with several innovations being made. These innovations include comprehensive evaluation approaches, student potential-oriented assessments, the utilization of observational results from the learning process, and the use of information technology to enhance the accessibility of the evaluation process. Further research is recommended on the application of evaluation guidelines in the affective and psychomotor domains within Islamic education at the high school level to complement the findings of this study.

“Taking This Course Triggered a Change in Me”: First-Generation Students’ Reported Outcomes From a Self-Regulated Learning Course

ABSTRACT This qualitative case study explored first-generation students’ self-reported outcomes from participating in a self-regulated learning course. Self-regulated learning is the process of planning, implementing, and evaluating one’s learning skills and strategies in the affective, behavioral, and cognitive domains. I analyzed four semesters’ worth of written coursework from 46 students, resulting in four key themes: increasing metacognition, adopting and practicing effective academic skills, shifting mind-set and self-talk, and defining personally meaningful success. The results suggest first-generation students may benefit from asset-based, proactive academic success interventions that address both cognitive and non-cognitive skills. Practical strategies for teaching are addressed.

Competency Model: Professional Development of Leisure Scuba Diving Instructors in China

Scuba diving specialization is a multidimensional index consisting of behavioral, cognitive, and affective domains. Based on the literature, the recreational scuba divers’ specialization was an interesting research topic to understand further the competency of leisure scuba diving instructors and prepare for their professional development. Leisure diving instructors need to carry out important duties such as teaching, underwater tour guides, safety protection, and equipment installation. The limitations of recreational scuba divers in China impact their specialization and competency as instructors. The study examined the qualities of an excellent leisure scuba diving instructor and the necessary professional enhancement they needed to become excellent leisure scuba diving instructors. Through qualitative methods, it revealed that leisure scuba diving instructors in China were 31 years old and older and possessed positive competencies in terms of their diving professional knowledge, skills, and attitude. However, they were average or unexceptional in their career opportunities, training, and mentorship and scored low in underwater photography, post-conference with students, and self-evaluations which were integrated into the professional development program as the output of the study.

The need to identify anatomy-related competencies in medical education.

A profound grasp of anatomy is indispensable for shaping competent and safe medical practitioners. This knowledge acquisition is pivotal in the early stages of medical education and remains crucial throughout clinical training. However, the evolving landscape of medical education has ushered in changes to the anatomy curriculum, marked by a reduction in contact hours and a streamlined content structure to accommodate novel subjects and teaching methodologies. This transformation has precipitated a quandary in defining the essential scope and depth of anatomical knowledge to be imparted. Traditionally, surgeons assumed the role of anatomy instructors until Flexner's recommendations catalyzed the integration of trained anatomists. Nevertheless, the varied backgrounds of anatomists and the heterogeneity in anatomy curricula across institutions have introduced potential disparities in the quality of graduates. Addressing these challenges mandates the identification of key anatomy competencies tailored for undergraduate medical students. The imperative lies in ensuring that these competencies span cognitive, psychomotor, and affective domains, offering not only comprehensiveness but also direct applicability to clinical practice. Hence, this viewpoint highlights the necessity of adopting a systematic approach that includes gathering input from various stakeholders in developing and implementing a universal anatomy core competency framework, ensuring graduates are equipped for the multifaceted demands of clinical practice. Overall, the manuscript provides a comprehensive overview of the challenges and opportunities in anatomy education, with a clear call to action for a transformative approach to meet the evolving needs of medical practice.

Contextual Considerations for the Neuropsychological Assessment of Pediatric mTBI

AbstractMild traumatic brain injury (mTBI), also known as concussion, is a common injury in the pediatric population. In 2014, children aged 0 to 19 made up 32% (812,000) of the 2.5 million TBI-related emergency department visits in the United States, which does not reflect the much higher number of children with a brain injury who do not present to medical centers (Black & Zablotsky, 2021). Similar to psychiatric diagnoses, a diagnosis of mTBI/concussion is made using clinical features and symptoms that are classified under cognitive, affective, and somatic domains, with none of the symptoms pathognomonic for TBI. Symptoms secondary to a mTBI are time limited and show a typical trajectory, and in a majority of cases, lead to full resolution. When this expected pattern is not observed, contributing comorbid and premorbid factors need to be considered for a thorough understanding of etiology. Accurate psychoeducation and prompt intervention, which begin with early screening (e.g., vulnerabilities, comorbidities, risk factors), are needed to empower the systems that support a child. Although comorbid factors are many and a thorough review is outside the scope of this case series, the three cases presented represent a common constellation of factors (e.g., neurodevelopmental, environmental, and adverse/traumatic experiences) that interplay with contextual factors in a diagnostic workup and treatment planning. This case series will also present relevant literature to briefly introduce various social and cognitive outcomes following mTBI relative to more severe injuries, define aspects that differentiate mTBI from more severe injuries, and discuss the influence of environment and other contextual factors across the severity spectrum.