Rasch Properties of the Cognitive and Linguistic Scale and Optimization for Outcome Trajectory Modeling in Pediatric Acquired Brain Injury.
Adrian M Svingos, Stacy J Suskauer, Beth S Slomine and 3 others
PMID 34728191WHAT IT FOUND
The Cognitive and Linguistic Scale works for tracking recovery if arousal and responsivity items are excluded from analysis.
Children who started recovering later achieved lower final cognitive ability. Older children recovered faster, but this did not change their final outcome.
Key findings
01Excluding the arousal and responsivity items improved the scale's fit for modeling, but these items must still be administered clinically because low scores on them influence the scoring of subsequent items.
02There was a significant negative correlation between the delay in starting recovery and the eventual extent of recovery, meaning late-starting recoveries tended to be poor.
03Older children demonstrated a faster rate of recovery, with the half-life of recovery decreasing by 2.5% for each year of age at injury.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was retrospective and conducted at a single rehabilitation hospital, so the results may not apply to other settings or patient populations. The mathematical model for recovery was chosen based on how well it fit the data, not on a pre-existing biological theory of brain recovery. Removing the arousal and responsivity items for analysis created a 'floor effect,' meaning the new score might not accurately distinguish between children with the most severe cognitive impairments. The group of children with non-traumatic brain injuries was very small and diverse, making it difficult to draw firm conclusions about how injury type affects recovery speed.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not stop administering the arousal and responsivity items just because they were removed from the statistical analysis. The study explicitly states that these items must remain in clinical use because low scores on them influence the scoring rules for the rest of the assessment.