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Decision-making is often impacted by paediatric traumatic brain injury (TBI). However, there are few tools available to assess these skills in children, with even less research on the consequences of decision-making deficits on dysregulation following TBI. This prospective preliminary study investigated whether decision-making mediated the effect of TBI on dysregulation in children. The performance of school-aged children aged between 7 and 15 years with TBI (n = 49) and that of typically developing controls (n = 22) was compared on The Decision-making Task, and on parent ratings of the dysregulation profile as characterized by the Child Behaviour Checklist-Dysregulation Profile. Relative to the Control group, the TBI group performed more poorly on the decision-making task, and parents of the TBI group rated their children to be more poorly on the dysregulation profile. Mediation analyses indicated that decision-making mediated the relationship between TBI and the dysregulation profile. Our preliminary findings suggest the need for further research in the area of decision-making, and its impact on dysregulated behaviours in children following TBI.

Assessment measures that quantify decision-making abilities in children and adolescents are limited. In the current study, a novel computerized Decision-Making Task (DMT), which identifies the process that is involved in decision-making, was developed based on an existing information-boards paradigm. The overall aim was to validate the DMT in a paediatric TBI population. This prospective study investigated the performance on the DMT for children post-TBI (n = 49; 7–15 years) compared to typically developing controls (n = 22; 7–15 years), and investigated the psychometric properties of the DMT by examining internal consistency-related reliability, convergent validity (measures of decision-making, working memory, functional outcomes, and behaviour), and divergent validity (vocabulary). Significant differences were detected for performance on the DMT between children post-TBI and the control group. Psychometric properties of the DMT were acceptable, with variable findings for convergent validity (working memory, functional outcomes, and behaviour). This is the first study to develop and investigate a novel computerised task to assess decision-making skills in a paediatric TBI population. Results cautiously suggest that the DMT is a valid and a reliable measure of decision-making in our clinical sample.

Background Children with acquired brain injuries (ABI) often present with poor self-regulation and disruptive behaviour. Children with poor self-regulation are more likely to present with novel mental health problems. Poor self-regulation is a core aspect of disruptive behaviour. Disruptive behaviour risks child safety and undermines their participation in the community. Deficits in self-regulation and disruptive behaviour are exacerbated by the presence of dysfunctional parenting practices as well as high levels of parental trait anxiety, parental stress and social risk. The dysregulation profile has been used to identify children who are at risk of mental health problems in non-clinical paediatric populations. A cognitive behaviour therapy intervention parenting programme (Signposts) seems to be effective in decreasing child disruptive behaviour, dysfunctional parenting practices and parental stress following ABI. The current study aimed to investigate the contribution of parents’ characteristics to self-regulation and disruptive behaviour in children and to then assess the effectiveness of Signposts in reducing children’s disruptive behaviour along with dysfunctional parenting practices following ABI. Methods The study was conducted in Mexico where parents of 77 children with ABI participated in the study. Children and their parents were assessed. The children’s teachers also completed questionnaires regarding the child’s disruptive behaviour. These assessments were conducted prior to the intervention, immediately following the intervention and three months post- intervention. Results and Conclusion This study identified high levels of parent trait anxiety and child disinhibition as major contributors to children’s disruptive behaviour following ABI. Within a Mexican population, distal environmental factors (i.e. parents’ levels of education, their occupations) did not seem to be related with child impairment, whereas proximal environmental factors (i.e. parentin