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Should Young Children with Traumatic Brain Injury Be Compared with Community or Orthopedic Control Participants?
Miriam H Beauchamp1,2, Catherine Landry-Roy1,2, Jocelyn Gravel2
11 Department of Psychology, University of Montreal , Montreal, Quebec, Canada .
Insights
Orthopedic injury (OI) controls showed no significant differences compared to community controls (CC) in young children. This suggests no clear advantage of using OI controls in pediatric traumatic brain injury (TBI) research based on current variables.
Area of Science:
- Pediatric neurology
- Developmental psychology
- Clinical research methodology
Background:
- Pediatric traumatic brain injury (TBI) research often uses orthopedic injury (OI) or community controls (CC).
- OI controls are theoretically ideal due to shared injury experiences, but their added value in pediatric TBI is debated.
- Comparability between OI and CC groups in young children has not been established.
Purpose of the Study:
- To compare the comparability of orthopedic injury (OI) and community control (CC) groups in preschool children.
- To determine if OI controls offer an advantage over CC in pediatric TBI research.
Main Methods:
- Seventy-two children with OI and 84 CC (aged 18-60 months) were assessed.
- Comparisons included demographics, medical/developmental history, pre-injury behaviors, and post-injury functioning (adaptive, behavioral, family, cognitive).
- Assessments were conducted 6 months post-injury for the OI group.
Main Results:
- No statistically significant differences were found between the OI and CC groups on any tested variables.
- This includes pre-injury characteristics, demographics, and post-injury outcomes like cognition and behavior.
- The findings indicate similar profiles between the two control groups at 6 months post-injury.
Conclusions:
- Orthopedic injury controls do not appear to offer a clear advantage over community controls in pediatric TBI research for the variables studied.
- The methodology and variables examined do not support the preferential recruitment of OI controls in preschool TBI studies.
- Further research is needed to explore other factors and earlier time points post-injury.
Abstract:
Pediatric traumatic brain injury (TBI) research depends on comparisons of profiles and outcomes between brain-injured individuals and groups consisting either of injured controls (e.g., orthopedic injuries, OI) or uninjured, typically developing children recruited from the community (community controls, CC). Children with OI are thought to provide optimal comparisons for individuals with TBI because they share injury-related experiences and pre-morbid characteristics; however, a study by Mathias and colleagues (2013) 1 in adults has called into question the added value of injury control groups in TBI research. The comparability of these control groups has not been established in young children. Seventy-two children with OI and 84 CC aged between 18 and 60 months were compared on a range of demographic variables, developmental and medical history, pre-injury behavioral and adaptive profiles, as well as on measures of adaptive functioning, behavior, family functioning, post-concussive symptoms, and cognition (intellectual functioning, verbal abilities, executive functioning, social cognition) 6 months after the OI. There were no statistically significant differences between the OI and CC groups on any of the variables tested, whether they related to pre-injury or post-injury characteristics. The findings are applicable to studies seeking to identify appropriate control groups in the context of preschool TBI research, and suggest no clear advantage in recruiting OI controls based on the variables studied and the methodology used. However, further work is necessary to verify additional factors and outcomes relevant to pediatric TBI research, as well as to compare outcomes between these two groups at more acute stages (i.e., prior to 6 months post-injury).