PROJECT TITLE Virtual Reality-based Rehabilitation for Children with Traumatic Brain Injuries PROJECT SUMMARY/ABSTRACT Jiabin Shen, PhD, is a Research Scientist (postdoc equivalent position) in the Center for Pediatric Trauma Research at The Research Institute at Nationwide Children?s Hospital (NCH). His long-term career goal is to become an accomplished research scientist with a programmatic line of research focused on theory-driven and technology-assisted psychological rehabilitation for childhood TBI. Childhood TBI is a leading cause of acquired disability in U.S. children with 700,000 cases every year, which often result in significant impairment in broad cognitive functions, particularly in executive functions (EFs) that are critical to children?s development, especially in children with moderate to severe TBI. Although the Centers for Disease Control and Prevention (CDC) has identified post-TBI cognitive rehabilitation as the top unmet health care need for children with TBI, interventions specifically designed for children?s EF rehabilitation post-TBI remain unavailable. Virtual reality (VR) offers exciting potential as an alternative strategy for EF rehabilitation of childhood TBI for its flexibility in training content, capability for affordable remote access, and potential of increased adherence and skill transfer. However, the safety/efficacy of VR-based EF rehabilitation of childhood TBI remains to be established. This Pathway to Independence Award (K99/R00) proposal outlines structured career development and research plans aiming to assess the safety and efficacy of an innovative VR-based EF training program for children with moderate to severe TBI. During the K99 phase, Dr. Shen will conduct a small parallel-group randomized clinical trial (RCT) to evaluate the VR research paradigm, safety, and preliminary efficacy of the intervention among 30 children 7-17 years with moderate to severe TBI. Coupled with a structured training plan, the K99 phase will help Dr. Shen gain expertise in: (1) childhood TBI rehabilitation and outcome assessment, (2) technology-assisted childhood TBI rehabilitation, and (3) advanced design and analysis for RCTs in pediatric rehabilitation settings. Dr. Shen?s research and training during the K99 phase will be supported by the mentorship of an established and multidisciplinary team with extensive expertise in guiding trainees to successful academic careers as independent investigators, as well as the Inpatient Rehabilitation Unit and research core services at NCH. Along with the career development support from his Scholarship Oversight Committee, the K99 award will ensure Dr. Shen?s successful transition to the R00 phase as an independent tenure-track assistant professor in pediatric rehabilitation research. During the R00 phase, Dr. Shen will conduct a full-scale parallel-group RCT to formally evaluate the efficacy of the VR program on children?s core EFs, daily EFs, attention problems, and health-related quality-of-life outcomes. The expertise and skills gained from this K99/R00 award will inform the development of a comprehensive VR program for cognitive, emotional, and social rehabilitation among children with TBI and other acquired brain injuries.
Childhood traumatic brain injury (TBI) poses significant impairment in children?s executive functions (EFs) for moderate to severe injuries, yet interventions specifically designed for children?s EF rehabilitation post-TBI and rigorous clinical trials to establish the safety and efficacy of such interventions remain unavailable. In this study, we propose two phases of randomized clinical trials to evaluate the safety and efficacy of a novel virtual reality (VR)-based training program for EF rehabilitation for moderate to severe childhood TBI. Knowledge from this research will improve the long-term health and quality of life in children with TBI, as well as promote efficiency and effectiveness of future psychological rehabilitation for children with TBI.