An analysis of performance by traumatic brain injured children and adolescents on the test of memory and learning (TOMAL)

78 Abstractsfrom the 17thAnnualMeeting AmericanIndian substanceabusers.A numberof previousstudieshave demonstratedhow Cognistatcan producea highrate of false-negativeor false-positiveidentificationsdepending on samplingcharacteristics.Cognistatpurportsto measuremultipledomainsof cognitive functioning.Standardizationstudieson the Cognistathavetypicallynot includedadolescents (agerange 20 to 92 yearsold).Narrowsubgroupingsof adolescents(15–19-year-olds)have been reportedin the literature(Logueet al., 1993).There are no publishedstudieson how substanceabusersin general,or adolescentsubstanceabusersin particularperformon the Cognistat.Additionally,no studiesof adolescentNativeAmericanIndian substanceabusers are available.In the presentstudytwo broaderagerange(13–18-year-old)groupsof recently hospitalizedadolescentsubstanceabusers(NativeAmerican,N= 22 and Caucasian,N = 24) were administeredthe Cognistatas part of a larger psychologicalscreening assessment performedwithin two weeks of admissionto chemicaldependencytreatment.Analysisof variance(ANOVA)wasusedto compareNativeAmericanIndianand Caucasianadolescents on the Cognistat.Our findingsindicate significantculturalbiases/issues(F = 10.16,p = .0026)on selectedlanguageitemson theCognistat.In thisresearchtheCognistatwouldhave resulted in false-positiveidentificationin this Native American Indian adolescentgroup. Therefore,culturalbiases/issuesneed to be advancedfor this populationwhen subjectedto such a cognitivescreeninginstrument. Lajiness-O’Neill,R. R., Foley,H. A., Bigler,E. D., & Burlingame,G. M. An Analysis of Pe~ormance by Traumatic Brain Injured Children and Adolescents on the Test of Memory and Learning (TOMAL). The Testof Memoryand Learning(TOMAL)is a comprehensivebatterywhichhas recently been developedto assess memory functioningin children and adolescents(Reynolds& Bigler,1994).Previousstudieshavenot been undertakento evaluatethe efficacyof utilizing the TOMAL with a clinical population.The following study was conducted using the TOMAL with 65 traumaticbrain-injured(TBI) and 65 control children and adolescents. Differencesin performancein brain-injuredand control subjectsrelative to severity (i.e., GlasgowComa Scores (GCS) and length of coma) was examined.An examinationof the differencesin performanceon the TOMALsubtestsrelativeto severityof injury was also examined.An analysisof variancerevealedsignificantgroupdifferenceson all indicesof the TOMALincludingtheVerbalMemoryIndex(VMI)(F(3,126)= 12.75,P < .001);Nonverbal Memory Index (NMI) (F(3,126) = 10.42,p < .001); CompositeMemory Index (CMI) (F(3,126)= 15.03,p < .001);and DelayedMemoryIndex (DMI) (F(3,126)= 12.03,p < .001)with performancegenerallylinearlyrelatedto severity.On the average,a 15 point (1 SD) differencein performanceon the TOMALIndiceswas notedbetweenindividualswith severeinjuriesand controlsubjects.Posthoc analysesrevealedsignificantgroupdifferences betweenthe severebrain injurygrouprelativeto the moderate,mild, and controlgroupson the VMI. Significantgroup differencesbetween severe and moderatebrain injury groups werefoundwhencomparedto the controlgroupon the NMI, CMI,and DRI. The mildbrain injurygroupwas not significantlydifferentfromthe moderatebraininjurygroupon TOMAL Indices,but was significantlydifferentfromthe severebraininjurygroupon the VMI, CMI, and DRI scoreof the TOMAL.The mild brain injurygroupwas also significantlydifferent fromthe controlgroupon the CMI.An examinationof whichTOMALsubtestsprovidedthe most reliabledifferencesbetweenthe controland brain-injuredgroupswas also explored. The results suggesta relativepreservationof VerbalMemoryfunctioningexcept in severe injuries. The sensitivityof the TOMAL CompositeI,ndexand vulnerabilityof memory functioningin evenmildinjuriesis elucidated.Theindistinguishableperformanceon specific subtestsby the moderateand mild brain injurygroupsis hypothesizedto reflectthe relative vulnerabilityof complexvisualmemoryabilitiesthat may requiresignificantverbalmedi Abstractsfrom the 17thAnnualMeeting 79 ation for encodingeven in mild injuries.Furtherimplicationsof the precedingfindings,as well as the el%cacyof using the TOMALwith this clinicalpopulation,will be discussed. Levick,W. R. Developmental Amnesic Syndrome: Two Case Studies. There has been considerableclinical, research and theoreticalexaminationof acquired amnesicsyndromesparticularlyin adultsubjects.In recentyears a few detailedcase studies of acquiredamnesicsyndromein childrenhave been published.In contrastthere has been very limited discussionof the conceptof a developmentalamnesicsyndrome.This paper examinesthe conceptof a developmentalamnesicsyndromein the lightof two case studies. The casesCJ and GD, both n-year-old boys,are presented.Neitherhas a historyto suggest acquiredbraindysfunction.Detailedmemorytestfindingsarepresentedtogetherwithresults of more completeneuropsychologicalexaminationand assessmentof educatiomdattainments. CJ and GD present similar patterns of memory deficit on testing with relative preservationof immediatememoryspan and severeimpairmentin delayedrecall of verbal and nonverbalmaterial.Whilerecognitionwas in most cases significantlybetterthan recall it was still generallybelow average. CJ and GD also presentedwith similar patterns of behaviorproblemsbothnotablefortheiraggressiveanddestructiveclassroombehavior.They differedsignificantlyin globalmeasuresof intelligenceandin academicattainments.Results are comparedwithpatternsof memorydeficitin acquiredamnesicsyndromes.Possiblelinks betweenmemorydeficitsand othercognitivedeficits,educationalattainmentsand behavior are discussed. Finally the implicationsfor practice and theory in chikUdevelopmental neuropsychologyare considered. Lewis,J. K., Morris,M. K., Morris,R. D., & Foster,M. A. Social Problems Solving Ability in Children with Acquired Brain Injuries. Childrenwith acquiredbrain injuries(ABI) have been describedas less sociallycompetent on parent report measures;however,there has been limited direct assessmentof specific socialskillsin thispopulation.Thisstudycomparedthirty-onechildrenwithABI, ages6-12, to31 controlsubjects,matchedon age, sex,andethnicity,on the SocialKnowledgeInterview (SKI),an analogmeasureof socialproblemsolvingskills.The majorityof ABI subjectshad experiencedeithera traumaticbraininjury(n = 12)or a braintumor (n = 15).Usingmatched pairs t-tests,severaldependentmeasureswere examinedincludingthe numberof possible responsesgeneratedfor eachproblemscenario,the qualityof thoseresponses,and the ability to select the best responsefrom a set of alternatives.Childrenwith ABI generatedmore assertiveresponsesthan matchedcontrolsand were less likelyto selectthe best responsein a multiplechoiceformat.A trendfor childrenwithABI to generatefewerpossibleresponses was alsoobserved.In bothgroups,performanceon theSKIwaspositivelycorrelatedwithIQ. In childrenwithABI,performancewas alsorelatedto medicalvariables(i.e.,primarylesion location,radiation treatmen (...truncated)