Cognitive Communication Impairment in Childhood Traumatic Brain Injury
Bibliographic record
Abstract
Cognitive communication impairments are common sequelae of traumatic brain injury (TBI) but remain understudied in the paediatric academic literature. To synthesize the literature addressing cognitive communication impairments in childhood TBI and identify research priorities for the field, I completed a scoping review (Study 1); the three main findings of which guided my doctoral research. First, my scoping review identified younger age at injury as a significant contributor to negative cognitive communication outcomes with little known about language outcomes in early childhood TBI. To address this knowledge gap, I completed a retrospective chart review of the medical records at Holland Bloorview Kids Rehabilitation Hospital in Toronto, Ontario, Canada to characterize the communication performance of preschoolers within 3 months post-TBI (Study 2). Extracted language scores were broadly within average, with pre-injury language levels and dual-language learning likely contributors to performance. Second, my scoping review identified phonemic fluency as a sensitive measure for detecting cognitive communication impairment. However, no study included in my scoping review used semantic fluency, a measure that can be administered to younger children. To better understand the estimated the effects of injury by verbal fluency type (e.g. phonemic and semantic), severity, and over time I conducted a systematic review and meta-analysis (Study 3). Results revealed larger effects for phonemic fluency than semantic, severe TBI compared to mild and moderate TBI, and persisting effects of injury over time. Third, my scoping review identified that cognitive communication impairments persist after childhood TBI with little known about the effects of injury on the application of lexical knowledge. I conducted a systematic review and meta-analysis study to examine the estimated effects of pediatric TBI on verbal intelligence by severity and over time (Study 4). Results revealed larger effects in severe TBI compared to mild and moderate TBI and persisting effects of injury over time. Together, my dissertation identified language measures that may assist with earlier identification of cognitive communication impairments in paediatric TBI and individual factors that may assist with the personalization of paediatric TBI management.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.034 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.005 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".