Assessment of higher level cognitive-communication functions in adolescents with ABI: Standardization of the student version of the functional assessment of verbal reasoning and executive strategies (S-FAVRES)

Abstract

Background: Childhood acquired brain injuries can disrupt communication functions needed for success in school, work and social interaction. Cognitive-communication difficulties may not be apparent until adolescence, when academic, environmental and social-emotional demands increase.

Objective: The Functional Assessment of Verbal Reasoning and Executive Strategies for Students (S-FAVRES) is a new activity-level measure of cognitive-communication skills in complex, contextual and integrative tasks that simulate real world communication challenges. It is hypothesized that S-FAVRES performance would differentiate adolescents with and without acquired brain injury (ABI) on scores for Accuracy, Rationale, Reasoning Subskills and Time.

Methods: S-FAVRES was administered to 182 typically-developing (TD) and 57 adolescents with mild-to-severe ABI aged 12–19. Group differences, internal consistency, sensitivity, specificity, reliability and contributing factors to performance (age, gender, brain injury) were examined statistically.

Results: Those with ABI attained statistically lower Accuracy, Rationale and Reasoning sub-skills scores than their TD peers. Time scores were not significantly different. Performance trends were consistent across tasks, administrations, gender and age groups. Inter-rater reliability for scoring was acceptable.

Conclusion: The S-FAVRES provides a reliable, functional and quantifiable measure of subtle cognitive-communication difficulties in adolescents that can assist speech-language pathologists in planning treatment and integration to school and real world communication.

Keywords:

• Cognitive-communication
• mild brain injury
• mTBI
• concussion
• acquired brain injury
• adolescent
• paediatric
• assessment
• communication
• reasoning
• executive functions

Acknowledgements

I would like to thank Arlene Margosian, Virginia Graham and Bonnie Swantek for their dedicated assistance with pilot studies, data collection and analysis. I would also like to express my gratitude to the 46 speech-language pathologists and research scientists who provided valuable input as test site clinicians. Thanks go especially to Lyn Turkstra and Carla Johnson whose input inspired the genesis of this project and to Catherine Wiseman-Hakes, Michelle Cohen and Elyse Shumway for their clinical insights. Sincere appreciation is also extended to members of the Upper Grand District School board, particularly Debbie Shaw, for assistance with recruitment. Charles Victor and Olga Shestakovska provided crucial statistical expertise. Finally, I would like to express my appreciation to all of the students and their parents whose enthusiasm, participation and feedback made the development of the S-FAVRES possible.

Declaration of interest

The author has financial interest in the company CCD Publishing, the publisher of the S-FAVRES.