Resilience and the mediating effects of executive dysfunction after childhood brain injury: A comparison between children aged 9-15 years with brain injury and non-injured controls

Primary objective: Acquired brain injury (ABI) during childhood can be associated with enduring difficulties related to impairments to executive functioning (EF). EF impairments may detrimentally affect outcome by restricting an individual's ability to access 'resiliency' resources after ABI. Research design: The purpose of this study was to explore whether there is deterioration in children's resilience compared with peers after ABI and whether EF is influential in mediating relationships between resilience and behaviour. Methods and procedures: Measures of resilience, depression and anxiety were administered with 21 children with ABI and 70 matched healthy children aged 9--15 years. Parents completed measures of behaviour and EF. Main outcomes and results: Children with ABI were identified as less resilient and more depressed and anxious than controls. Resiliency measures were correlated with depression and anxiety in both groups. Relationships between resiliency and socio-emotional behaviour were mediated by EF. Conclusions: Assessment of resilience after ABI may be useful in supporting or defining the delivery of more individualized rehabilitation programmes according to the resources and vulnerabilities a young person has. However, an accurate understanding of the role of EF in the relationship between resilience and behavioural outcome after ABI is essential.