Measuring domain-specific deficits in self-awareness in children and adolescents with acquired brain injury: Component analysis of the Paediatric Awareness Questionnaire

• Published in: Neuropsychological rehabilitation 2022-09, Vol.32 (8), p.1814-1834
• Main Authors: Lloyd, Owen, Ownsworth, Tamara, Zimmer-Gembeck, Melanie J., Fleming, Jennifer, Shum, David H. K.
• Format: Article
• Language: English
• Subjects: Acquired brain injury; Activities of daily living; Adolescents; Brain injured children; Children; Cognition; Cognitive ability; Cognitive functioning; Communication skills; Emotional well being; Emotions; Functional impairment; Metacognition; Pediatrics; Principal components analysis; Questionnaires; Rehabilitation; Rotation; Self awareness; Self-recognition; Selfawareness; Teenagers; Traumatic brain injury
• ISSN: 0960-2011; 1464-0694
• DOI: 10.1080/09602011.2021.1926290

Self-awareness has been found to vary across different functional domains for adults with acquired brain injury (ABI); however, domain-specific self-awareness is yet to be investigated following paediatric ABI. This study aimed to validate the Paediatric Awareness Questionnaire (PAQ) as a multi-domain measure of self-awareness and to investigate domain-specific self-awareness in children with ABI. One hundred and ninety-seven children and adolescents (8-16 years, M = 12.44, SD = 2.62) with mixed causes of ABI (70% with traumatic brain injury) and their parents (n = 197) were recruited through consecutive rehabilitation appointments and completed the PAQ. The 37 items of the parent version of the PAQ were subjected to a principal component analysis with varimax rotation. A five-component solution (29 items) explained 64% of the variance in the PAQ items. Components revealed five domains of self-awareness: socio-emotional functioning, activities of daily living (ADLs), cognition, physical functioning, and communication. Internal consistency of the components ranged from acceptable to excellent (α = .70-.95). The analysis identified that children had poorer self-awareness of cognitive functioning than socio-emotional functioning, ADLs, and communication skills. Overall, the findings identify five components (i.e., functional domains) of self-awareness and provide some support that self-awareness varies across domains following paediatric ABI.