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Impairments in Learning, Memory, and Metamemory Following Childhood Head Injury

Crowther, Jason E. PhD; Hanten, Gerri PhD; Li, Xiaoqi MS; Dennis, Maureen PhD; Chapman, Sandra B. PhD; Levin, Harvey S. PhD

The Journal of Head Trauma Rehabilitation: May/June 2011 - Volume 26 - Issue 3 - p 192–201
doi: 10.1097/HTR.0b013e318218dd22
Original Article

Objective: To assess postinjury changes in learning, memory, and metamemory abilities following childhood traumatic brain injury.

Design: Prospective, longitudinal with 5 assessments made from baseline to 24 months postinjury.

Participants: A total of 167 children (aged 5–15 years) with traumatic brain injury (TBI; 64 severe, 55 moderate, and 48 mild).

Methods: Children completed a judgment of learning task with 4 recall trials and made 3 metamemory judgments.

Results: Relative to those with mild TBI, children with moderate or severe TBI performed worse at earlier times postinjury and had a greater change in performance over time. Performance for moderate and severe groups peaked at 12 months and the performance gap between them and mild TBI group increased slightly from 12 to 24 months. Traumatic brain injury severity did not affect initial study-recall trial performance, but groups did diverge in performance with repeated study. Greater TBI severity was associated with poorer performance on prospective metamemory judgments, but not retrospective judgments.

Conclusions: Traumatic brain injury severity affected prospective judgments of memory performance and learning strategies, but did not appear to affect either word retention or the forgetting of words over a delay. Implications for rehabilitation are discussed.

Cognitive Neuroscience Laboratory, Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas (Drs Crowther, Hanten, Levin and Ms Li); Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Dennis); and Center for Brain Health, University of Texas, Dallas (Dr Chapman).

Corresponding Author: Gerri Hanten, PhD, Baylor College of Medicine, 1709 Dryden Rd, Ste 1200, Houston, TX 77030 (

This research was supported by the National Institute of Neurological Disorders and Stroke; Grant no. NS-21889 to H.S.L. and by National Institute on Disability and Rehabilitation Research; training grant no. H133P080007 to J.E.C.

© 2011 Lippincott Williams & Wilkins, Inc.