Goal management training and psychoeducation for executive function in adolescents with paediatric-acquired brain injuries: a 5-year follow-up.

OBJECTIVE

To determine the long-term efficacy of pediatric Goal Management Training (pGMT) versus pediatric Brain Health Workshop (pBHW) in improving executive function (EF) among adolescents with pediatric-acquired brain injury (pABI).

METHOD: This study reports a 5-year follow-up of the CORE trial, which included participants aged 10-17 years at baseline, randomized to either pGMT or pBHW. EF was measured at five timepoints using the parent-rated Behavior Rating Inventory of Executive Function (BRIEF), including the Behavior Regulation Index (BRI) and the Metacognition Index (MI). Outcomes were evaluated using linear mixed models (n = 73) and Reliable Change Index (RCI) analyses (n = 34).

RESULTS

Significant improvements over time were observed for both BRI (F(4, 65.615) = 9.64, p < 0.001) and MI (F(4, 51.758) = 4.29, p = 0.004). No significant group differences were detected, indicating that both interventions were associated with comparable long-term trajectories. RCI analyses identified clinically meaningful improvements in 12 participants on the BRI (pGMT, n = 3; pBHW, n = 9) and 20 participants on the MI (pGMT, n = 6; pBHW, n = 11).

CONCLUSIONS

Adolescents with pABI showed sustained long-term gains in EF over five years following cognitive rehabilitation, with a notable proportion achieving clinical meaningful improvements. However, given study limitations, results should be interpreted with caution.