Online Awareness among Adolescents with Acquired Brain Injury: Preliminary Findings following Performance of Motor, Cognitive and Functional Tasks

Abstract

Aims: Online awareness is an ongoing ability to monitor performance within the stream of action. It involves the ability to detect errors emerging during actual performance, as well as to anticipate potential problems. This preliminary within-subject study aimed to evaluate emergent and anticipatory online awareness among adolescents with Acquired Brain Injury (ABI) during performance of motor, cognitive and functional tasks.

Methods: 14 adolescents (11-18 years) following ABI were recruited. Before and after completion of the tasks, participants fulfilled task-related awareness questionnaires.

Results: In the motor task, no significant correlations were found between heart rate and the subjective perceived exertion scale (emergent awareness). In the cognitive task, no significant correlations were found between the estimated difficulty before the task (anticipatory awareness) and actual performance, however a significant correlation was found between performance and the self-evaluation of performance (emergent awareness), in the easiest item of the task. In the functional task, two main patterns of online awareness were recognized: accurate and overestimation of performance.

Conclusions: Online awareness deficits in adolescents after ABI, vary as a function of task characteristics. Clinicians who aim to improve online awareness should direct interventions to mainly include functional tasks, as compared to cognitive and motor tasks.

Keywords:

• Self-awareness
• acquired brain injury
• children
• task characteristics
• rehabilitation

Acknowledgments

The authors extend their special appreciation to the families who participated in the study.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author.

Disclosure Statement

No potential conflict of interest was reported by the authors.

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Additional information

Notes on contributors

Miranda Snir Melamed

Melamed Snir, MSc, OT, is a former Occupational Therapist at the Department of Pediatric Rehabilitation. Currently an occupational therapist at the Pediatric Psychiatric Inpatient Unit at the Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Israel.

Tamar Silberg

Tamar Silberg, Ph.D, a licensed Rehabilitation Psychologist and Neuropsychologist, is a lecturer at the Department of Psychology, Bar-Ilan University, Israel, as well as a researcher at the Department of Pediatric Rehabilitation, the Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Israel.

Orly Bar

Orly Bar, OT, MSc, Head of occupational therapy services at the Department of Pediatric Rehabilitation, the Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Israel.

Amichai Brezner

Amichai Brezner, MD, is a pediatrician and the former director of the Department of Pediatric Rehabilitation at the Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Israel.

Janna Landa

Jana Landa, MD, Psychotherapist is an expert in Physical Medicine and Rehabilitation with 25 years' experience in Pediatric Rehabilitation and the Head of the Pediatric Rehabilitation Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center. She is a teaching member and a clinical instructor at The Sackler Faculty of Medicine, Tel-Aviv University, Israel.

Yafit Gliboa

Yafit Gilboa, OT, Ph.D. is an Occupational Therapist and a senior lecturer at the School of Occupational Therapy, Faculty of Medicine, The Hebrew University of Jerusalem, Israel.