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Recovery trajectories of IQ after pediatric TBI: A latent class growth modeling analysis
Megan E Narad1, Julia Smith-Paine1, Amy Cassedy1,2
1Cincinnati Children's Hospital Medical Center, Cincinnati, USA.
Insights
Pediatric traumatic brain injury (TBI) impacts nonverbal IQ recovery, with severity playing a role. Parenting style significantly influences long-term IQ recovery in children with TBI compared to orthopedic injuries.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatric Traumatic Brain Injury Research
Background:
- Pediatric traumatic brain injury (TBI) can have lasting effects on cognitive development.
- Understanding IQ trajectories post-TBI is crucial for effective intervention.
- Identifying factors that predict recovery is essential for optimizing outcomes.
Purpose of the Study:
- To identify latent IQ trajectories in children after TBI.
- To examine how risk factors predict recovery across different TBI trajectories.
- To compare IQ recovery patterns between TBI and orthopedic injury (OI) groups.
Main Methods:
- Latent class growth modeling was used to analyze IQ data from 206 children (ages 3-7) at three time points over 6.8 years.
- Included children with TBI (n=87) and orthopedic injury (OI, n=119).
- Assessed verbal and nonverbal IQ, considering injury severity, parenting style, and other demographic/environmental factors.
Main Results:
- Both TBI and OI groups showed three distinct latent classes for verbal and nonverbal IQ (below average, average, above average).
- TBI severity predicted nonverbal IQ trajectories, with less severe injuries correlating with higher scores; this was not observed for verbal IQ.
- Parenting style demonstrated a more significant impact on both verbal and nonverbal IQ trajectories in the TBI group compared to the OI group.
Conclusions:
- TBI severity is linked to nonverbal IQ recovery trajectories, but not verbal IQ.
- Parenting style exerts a stronger influence on IQ recovery following TBI than OI.
- Parental factors are critical for long-term cognitive recovery after pediatric TBI.
Objective:
To identify latent trajectories of IQ over time after pediatric traumatic brain injury (TBI) and examine the predictive value of risk factors within and across recovery trajectories.
Method:
206 children ages 3-7 years at injury were included: 87 TBI (23 severe, 21 moderate, 43 complicated mild) and 119 orthopedic injury (OI). We administered intelligence tests shortly after injury (1½ months), 12 months, and 6.8 years postinjury. Latent class growth modeling was used to identify latent subgroups. Separate models examined verbal and nonverbal IQ recovery trajectories following TBI versus OI. Variables included: age at injury, sex, race, socioeconomic status, injury severity, quality of the home environment, family functioning, and parenting style.
Results:
Both the TBI and OI analyses yielded different growth models for nonverbal (k = 3) and verbal IQ (k = 3). Although all models resulted in 3 latent classes (below average, average, and aboveaverage performance); trajectory shapes, contributors to class membership, and performance within each class varied by injury group and IQ domain. TBI severity was associated with class membership for nonverbal IQ, with less severe injuries associated with higher IQ scores; however, TBI severity did not influence verbal IQ class membership. Parenting style had a more prominent effect on verbal and nonverbal IQ within the TBI than OI trajectories.
Conclusions:
Findings suggest TBI severity is related to recovery trajectories for nonverbal but not verbal IQ and parenting style has stronger effects on recovery in TBI than OI. Results highlight the importance of parental factors on long-term recovery after TBI.
