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Behavioral Health Service Utilization and Unmet Need After Traumatic Brain Injury in Childhood
Megan E Narad1,2, Emily Moscato3,4, Keith Owen Yeates5
1Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Insights
Children with traumatic brain injury (TBI) have a high need for behavioral health services years after injury. Many children experience unmet needs, highlighting the importance of ongoing monitoring for persistent impairments.
Area of Science:
- Pediatric neurology
- Behavioral health
- Neuroscience
Background:
- Traumatic brain injury (TBI) in early childhood can lead to persistent impairments.
- Understanding long-term behavioral health needs after TBI is crucial.
Purpose of the Study:
- To examine the need for, utilization of, and predictors of behavioral health services in children with moderate-to-severe TBI.
- To compare these outcomes with a group of children with orthopedic injury (OI) approximately 6.8 years post-injury.
Main Methods:
- A cohort of 130 children (ages 3-7 at injury) with moderate-to-severe TBI or OI were followed up 6.8 years after hospitalization.
- Data on behavioral health service needs and utilization were collected and analyzed.
Main Results:
- Adolescents with TBI showed significantly higher rates of behavioral health need (38-69%) compared to those with OI (17%).
- Overall service utilization was low (10%), with no significant differences between injury groups.
- A high percentage (77%) experienced unmet needs, particularly white children and those receiving early treatment.
Conclusions:
- Children with early childhood TBI face lasting behavioral health challenges.
- High rates of unmet needs persist even years after injury.
- Long-term monitoring is essential to identify and address evolving needs and prevent complications.
Objective:
The need for behavioral health services, service utilization, and predictors of utilization was examined in children with moderate-to-severe traumatic brain injury (TBI) relative to a comparison group of children with orthopedic injury (OI) 6.8 years after injury.
Methods:
A total of 130 children hospitalized for moderate-to-severe TBI (16 severe and 42 moderate) or OI (72) between the ages of 3 and 7 years, who were enrolled at the time of injury at 3 tertiary care children's hospital and one general hospital in Ohio, and completed a long-term follow-up 6.8 years after injury were included in analyses.
Results:
Adolescents with TBI (moderate [38%] and severe [69%]) had significantly greater rates of need than those with OI (17%). Behavioral health services were utilized by 10% of the sample with no injury group differences (OI: 6%; moderate: 17%; severe: 13%). Early treatment and white race were associated with less service utilization; 77% had an unmet need, with no injury group differences (OI: 75%; moderate: 75%; severe: 82%). Rate of unmet need was greater among white than non-white children.
Conclusion:
Children who sustain a TBI in early childhood experience persistent and clinically significant impairments even years after injury. Rates of unmet need were high for all injury groups. Findings underscore the importance of long-term monitoring to identify developing needs and prevent significant complications/deficits.
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