Appraising and managing knowledge: Metacognitive skills after childhood head injury

The metacognitive skills of knowledge appraisal and knowledge management were studied in head-injured and normally developing children. Appraisal skills involve fact-based knowledge gained from experience and stored in long-term memory. In a task requiring analysis of linguistic knowledge, participants were asked to appraise well-formed sentences, sentences with semantic-pragmatic anomaly, and sentences with morphological and grammatical anomaly. Management skills involve monitoring and revising ongoing performance and making adjustments as information moves forward in time. In a referential communication task, participants were asked to monitor the adequacy of directions that were either unambiguous or ambiguous. Children with head injury and young, normally developing children showed poor metacognitive skills for both appraisal and management. Younger children had a deficient knowledge base and had difficulty deploying metacognitive skills; the deficits of children with head injury appeared to arise less from a deficient knowledge base than from problems in the sustained application of cognitive appraisal skills. Within the head injury group, poor performance was variously associated with a younger age at head injury, lower Glasgow Coma Scale scores, frontal brain contusions with coma, bilateral brain contusions, and left-sided brain contusions. The results are discussed in terms of how head injury in the immature brain affects the acquisition of metacognitive skills and how deficits in metacognition might be related to the reported problems of head-injured children in cognitive and behavioral self-regulation.