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Cognitive Intervention for Attention and Executive Function Impairments in Children With Traumatic Brain Injury: A Pilot Study

Treble-Barna, Amery PhD; Sohlberg, McKay Moore PhD; Harn, Beth E. PhD; Wade, Shari L. PhD

Section Editor(s): Caplan, Bruce PhD, ABPP; Bogner, Jennifer PhD, ABPP; Brenner, Lisa PhD, ABPP; Arciniegas, David MD

The Journal of Head Trauma Rehabilitation: November/December 2016 - Volume 31 - Issue 6 - p 407–418
doi: 10.1097/HTR.0000000000000200
Focus on Clinical Research and Practice, Part 5

Objective: To test the effectiveness of the Attention Improvement and Management (AIM) program, a cognitive intervention for improving impairments in attention and executive functions (EFs) after pediatric traumatic brain injury (TBI).

Setting: Tertiary care children's hospital.

Participants: A total of 13 children with complicated mild-to-severe TBI (average of 5 years postinjury) and 11 healthy comparison children aged 9 to 15 years completed the study.

Design: Open-label pilot study with a nontreated control group.

Main Measures: Subtests from the Test of Everyday Attention-for Children (TEA-Ch) and the Delis–Kaplan Executive Function System (D-KEFS), the self- and parent-report from the Behavior Rating Inventory of Executive Function (BRIEF), and the Goal Attainment Scale (GAS).

Results: Relative to the healthy comparison group, children with TBI demonstrated significant improvement postintervention on a neuropsychological measure of sustained attention, as well as on parent-reported EFs. The majority of families also reported expected or more-than-expected personalized goal attainment.

Conclusions: The study provides preliminary evidence for the effectiveness of AIM in improving parent-reported EFs and personalized real-world goal attainment in children with TBI.

Supplemental Digital Content is Available in the Text.

Department of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (Dr Treble-Barna); Communication Disorders and Sciences, University of Oregon, Eugene, Oregon (Dr Sohlberg); Department of Special Education and Clinical Sciences, University of Oregon, Eugene, Oregon (Dr Harn); Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (Dr Wade).

Corresponding Author: Amery Treble-Barna, PhD, Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 (

The authors would like to recognize the contributions of Jason Prideaux, Jennifer Taylor, Holly MacPherson, Stacey Raj, and Julia Smith.

This project was supported in part by grants from the Department of Education's National Institute on Disability and Rehabilitation Research (Center on Interventions for Children and Youth with Traumatic Brain Injury; Grant number H133B090010-10) and the Ohio Department of Public Safety Emergency Medical Services Program. This material does not necessarily represent the policy of these agencies, nor is the material necessarily endorsed by the Federal Government.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

The authors declare no conflicts of interest.

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