A Randomized Trial of Teen Online Problem Solving for Improving Executive Function Deficits Following Pediatric Traumatic Brain Injury

Objective: To examine the efficacy of teen online problem solving (TOPS) in improving executive function (EF) deficits following traumatic brain injury (TBI) in adolescence. Methods: Families of adolescents (aged 11-18 years) with moderate to severe TBI were recruited from the trauma registry of 2 tertiary-care children's hospitals and then randomly assigned to receive TOPS (n = 20), a cognitive-behavioral, skill-building intervention, or access to online resources regarding TBI (Internet resource comparison; n = 21). Parent and teen reports of EF were assessed at baseline and a posttreatment follow-up (mean = 7.88 months later). Results: Improvements in self-reported EF skills were moderated by TBI severity, with teens with severe TBI in the TOPS treatment reporting significantly greater improvements than did those with severe TBI in the Internet resource comparison. The treatment groups did not differ on parent ratings of EF at the follow up. Conclusions: Findings suggest that TOPS may be effective in improving EF skills among teens with severe TBI.