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Predicting longitudinal patterns of functional deficits in children with traumatic brain injury
Taryn B Fay1, Keith Owen Yeates, Shari L Wade
1Department of Psychology, The Ohio State University, OH, USA.
Insights
Children with severe traumatic brain injury (TBI) often show persistent functional deficits, but recovery patterns vary. This study tracked neuropsychological, behavioral, adaptive, and academic outcomes in children post-TBI.
Area of Science:
- Pediatric Neurosciences
- Neurorehabilitation
- Developmental Psychology
Background:
- Traumatic brain injury (TBI) in children can lead to long-term functional impairments.
- Understanding the longitudinal trajectory of these deficits is crucial for effective intervention.
- Previous research has not fully elucidated the diverse recovery patterns following pediatric TBI.
Purpose of the Study:
- To investigate longitudinal patterns of functional deficits in children with severe and moderate TBI compared to orthopedic injury controls.
- To identify predictors of different recovery trajectories across neuropsychological, behavioral, adaptive, and academic domains.
- To characterize the course of functional recovery from 6 months to 3-5 years post-injury.
Main Methods:
- Longitudinal study design involving children aged 6-12 years at injury.
- Assessment of neuropsychological, behavioral, adaptive, and academic functioning at 6 months, 12 months, and 3-5 years post-injury.
- Statistical analysis using multinomial logistic regression to identify patterns of deficits and recovery.
Main Results:
- Severe TBI was associated with a higher likelihood of persistent deficits across all functional domains.
- Severe TBI predicted behavioral deterioration and improvement in neuropsychological, adaptive, and academic functioning.
- Despite severe TBI, a significant proportion of children demonstrated no deficits in certain domains over time.
Conclusions:
- Pediatric TBI, particularly severe TBI, is linked to varied longitudinal functional outcomes.
- Recovery is not uniform, with some children showing persistent deficits while others improve in specific areas.
- These findings underscore the need for individualized assessment and intervention strategies for children with TBI.
Abstract:
Longitudinal patterns of functional deficits were investigated in 37 children with severe traumatic brain injury (TBI), 40 children with moderate TBI, and 44 children with orthopedic injuries. They were from 6 to 12 years of age when injured. Their neuropsychological, behavioral, adaptive, and academic functioning were assessed at 6 months, 12 months, and 3-5 years postinjury. Functional deficits (<10th percentile for age) were identified within each outcome domain at each occasion. Children were classified into 4 a priori longitudinal patterns of outcomes within domains (i.e., no deficits, improvement, deterioration, persistent deficits). In multinomial logistic regression analyses, severe TBI predicted an increased likelihood of persistent deficits in all outcome domains, as well as deterioration in behavioral functioning and improvement in neuropsychological, adaptive, and academic functioning. Severe TBI also predicted a greater total number of functional deficits across domains at each occasion. However, many children with severe TBI showed no deficits from 6 months to 4 years postinjury in 1 or more outcome domains. The findings help clarify the course of recovery for individual children following TBI.
