Purpose: Recent investigations into effects of intensity or distribution of aphasia therapy have provided moderate evidence supporting intensive therapy schedules on aphasia treatment response. The purpose of the present study was to investigate the feasibility of creating an intensive therapy session without extending the amount of daily time a person spends in treatment. Method: Individuals who presented with chronic anomia poststroke ( N = 8) participated in 2 weeks of a computerized, therapist-delivered, cued, picture-naming treatment. Dosing parameters for each session were 8 presentations of 50 pictures, totaling 400 teaching episodes per session. Results: Of the 8 participants, 6 achieved significant increases from baseline on trained items after 400 teaching episodes (i.e., 1 treatment hr), and the remaining 2 participants achieved significant increases from baseline after 1200 teaching episodes (i.e., 3 treatment hr). Maintenance data from 7 of the participants indicated that 6 participants maintained significant improvement from baseline on trained items. Conclusions: Given an intensive and saturated context, anomic individuals were surprisingly quick at relearning to produce problematic words successfully. Most participants demonstrated retention of the gains 2 months after treatment ended. The high density of teaching episodes within the treatment session (i.e., the intensive treatment schedule) may have contributed to the behavioral gains.

Background: Traumatic brain injury (TBI) poses a significant threat to children’s health. Cognitive rehabilitation for pediatric TBI has the potential to improve the quality of life following the injury. Virtual reality (VR) can provide enriched cognitive training in a life-like but safe environment. However, existing VR applications for pediatric TBIs have primarily focused on physical rehabilitation. Objective: This study aims to design and develop an integrative hardware and software VR system to provide rehabilitation of executive functions (EF) for children with TBI, particularly in 3 core EF: inhibitory control, working memory, and cognitive flexibility. Methods: The VR training system was developed by an interdisciplinary team with expertise in best practices of VR design, developmental psychology, and pediatric TBI rehabilitation. Pilot usability testing of this novel system was conducted among 10 healthy children and 4 children with TBIs. Results: Our VR-based interactive cognitive training system was developed to provide assistive training on core EF following pediatric TBI. Pilot usability testing showed adequate user satisfaction ratings for both the hardware and software components of the VR system. Conclusions: This project designed and tested a novel VR-based system for executive function rehabilitation that is specifically adapted to children following TBI.

Purpose With the adoption of the Common Core State Standards, expository texts gain prominence at all grade levels and for all disciplines. Although the linguistic and cognitive complexities of exposition pose challenges for all children, they may create additional challenges for children and adolescents with language difficulties. Therefore, this tutorial provides background information for clinicians regarding the structure, development, and specific difficulties associated with exposition across the 4 modalities of listening, speaking, reading, and writing. This background is intended to help direct the attention of researchers and clinicians to needed advances in knowledge and skill if the profession is to adequately support the population of children and adolescents who struggle with language. Method This tutorial is based on an extensive narrative review of articles identified using a systematic search process. Cited research studies are discussed qualitatively, but intervention studies are also characterized in terms of the strength of their research designs. This method is undertaken to highlight the strengths and weaknesses of the current state of research on these topics. Conclusions Future research needs are proposed to promote discussion among researchers and to prepare clinicians for the kinds of evidence they should be demanding as a basis for their practice.

Purpose: The purpose of the study was to determine (a) reliability of the spatial span as a nonverbal working memory (WM) task in individuals with aphasia, (b) whether participation in anomia treatment changed spatial span scores, and (c) the degree to which visuospatial WM predicted response to anomia treatment. Method: Eight individuals with chronic aphasia were repeatedly assessed on the forward and backward conditions of the spatial span over 4 weeks while undergoing treatment for anomia. Experiment 1 assessed reliability of the spatial span conditions and determined whether span scores changed after beginning anomia treatment. Experiment 2 investigated the spatial span as a predictor of anomia treatment success. Results: Results of Experiment 1 showed that 7 participants demonstrated stability of the forward condition of the spatial span, and 5 participants demonstrated stability of the backward condition across all sessions ( p = .05). No participants showed an effect of aphasia treatment on span performance in either condition. Experiment 2 found that the backward span condition significantly predicted anomia treatment effect size, F (1, 6) = 15.202, p = .008. Conclusions: Visuospatial WM abilities were highly predictive of response to anomia treatment, supporting an account of WM that includes a central processing mechanism.

Objective: To investigate factors associated with follow-up care adherence in children hospitalized because of traumatic brain injury (TBI). Design: An urban level 1 children's hospital trauma registry was queried to identify patients (2-18 years) hospitalized with a TBI in 2013 to 2014. Chart reviewers assessed discharge summaries and follow-up instructions in 4 departments. Main Measures: Three levels of adherence—nonadherence, partial adherence, and full adherence—and their associations with care delivery, patient, and injury factors. Results: In our population, 80% were instructed to follow up within the hospital network. These children were older and had more severe TBIs than those without follow-up instructions and those referred to outside providers. Of the 352 eligible patients, 19.9% were nonadherent, 27.3% were partially adherent, and 52.8% were fully adherent. Those recommended to follow up with more than 1 department had higher odds of partial adherence over nonadherence (adjusted odds ratio [AOR] = 5.8, 95% CI: 1.9-17.9); however, these patients were less likely to be fully adherent (AOR = 0.1; 95% CI: 0.1-0.3). Privately insured patients had a higher AOR of full adherence. Conclusions: Nearly 20% of children hospitalized for TBI never returned for outpatient follow-up and 27% missed appointments. Care providers need to educate families, coordinate service provision, and promote long-term monitoring.

BACKGROUND: Preschool children have the highest incidence of emergency department visits for traumatic brain injury (TBI) with the majority discharged home without a single point of entry into follow-up services. This paper describes families’ experi