Clinically significant behavior problems during the initial 18 months following early childhood traumatic brain injury.

Abstract

The present study looked at the emergence of clinically significant problems in behavior, executive function skills (EF), and social competence during the initial 18 months following TBI in young children relative to a cohort of children with orthopedic injuries (OI) and the environmental factors that predict difficulties postinjury. Children, ages 3-7 years, hospitalized for severe TBI moderate TBI, or OI were seen shortly after their injury (M = 40 days) and again 6 months, 12 months, and 18 months postinjury. Behavioral parent self-reports, demographic data, family functioning reports, and home environment reports were collected at injury baseline and each time point post injury. Results suggest that, compared to the OI group, the severe TBI developed significantly more externalizing behavior problems and EF problems following injury that persisted through the 18-month follow-up. Minimal social competence difficulties appeared at the 18-month follow-up, suggesting a possible pattern of emerging deficits rather than a recovery over time. Predictors of the emergence of clinically significant problems included permissive parenting, family dysfunction, and low SES. The findings are similar to those found in school-aged children.

Online Problem-Solving Therapy for Executive Dysfunction After Child Traumatic Brain Injury

“…[6][7][8][9][10][11][12][13] In particular, executive dysfunction after pediatric TBI is associated with functional problems across home, school, and community settings both in the shortand long-term after injury. [6][7][8][9][10][14][15][16][17][18][19][20] Better treatment of executive dysfunction after injury may lead to improved functioning in everyday settings. 21 Problem-solving training has demonstrated promise in various clinical populations [22][23][24][25][26] ; however, it has only been preliminarily explored in pediatric TBI.…”

Online Problem-Solving Therapy for Executive Dysfunction After Child Traumatic Brain Injury

“…[6][7][8][9][10][11][12][13] In particular, executive dysfunction after pediatric TBI is associated with functional problems across home, school, and community settings both in the shortand long-term after injury. [6][7][8][9][10][14][15][16][17][18][19][20] Better treatment of executive dysfunction after injury may lead to improved functioning in everyday settings. 21 Problem-solving training has demonstrated promise in various clinical populations [22][23][24][25][26] ; however, it has only been preliminarily explored in pediatric TBI.…”

Prospective study of myelin water fraction changes after mild traumatic brain injury in collegiate contact sports

“…For example, children who sustain a moderate-to-severe TBI before the age of 7 years have substantially worse short-and long-term outcomes than children who suffer a similar injury at an older age (Anderson, Bechara, Damasio, Tranel, and Damasio, 1999;Barnes, Dennis, and Wilkinson, 1999;Dennis, Wilkinson, Koski, and Humphreys, 1995;Ewing-Cobbs et al, 1997;Taylor and Alden, 1997;Verger et al, 2001). Behavioral changes and problems in adaptive functioning (i.e., coping skills) are the most persistent negative impacts of TBI in children (Anderson, Morse, Catroppa, Haritou, and Rosenfeld, 2004;Chapman et al, 2010;Fay et al, 2009;Schwartz et al, 2003). Older adults who sustain a TBI have lower survival rates and less favorable outcomes than those who sustain a TBI during young and middle adulthood (Frankel et al, 2006;Hukkelhoven et al, 2003).…”

“…In addition, students who sustain less severe injuries, concussions or mild TBIs, often fail to receive school accommodations despite recommendations that accommodations be made available for several weeks to months post-injury (Gioia, Kenworthy, and Isquith, 2010). As a consequence, both parents and school personnel can become frustrated and discouraged by a child' s continuing difficulties and disruption to their normative development (Chapman et al, 2010).…”