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Published on: January 30, 2018
Behavior problems 7 years after severe childhood traumatic brain injury: Results of the Traumatisme Grave de L'Enfant
Hugo Câmara-Costa1, Lilia Tokpo2, Leila Francillette2
1Laboratoire d'Imagerie Biomedicale (LIB), CNRS, INSERM, Sorbonne Universite.
Insights
Children with severe traumatic brain injury (TBI) often experience persistent behavioral problems, including externalizing and internalizing issues, years after injury. Long-term follow-up and tailored interventions are crucial for managing these challenges.
Area of Science:
- Pediatric Neuropsychology
- Developmental Psychology
- Clinical Psychology
Background:
- Severe pediatric traumatic brain injury (TBI) can lead to long-term neurodevelopmental deficits.
- Behavioral problems are common sequelae of TBI in children, impacting daily functioning and quality of life.
- Understanding the trajectory of these behavioral issues is essential for effective intervention.
Purpose of the Study:
- To investigate the occurrence and evolution of behavioral problems 7 years after severe pediatric TBI.
- To compare behavioral outcomes in children with severe TBI to a matched control group.
- To identify factors associated with behavioral problems post-TBI.
Main Methods:
- A cohort of 34 children with severe TBI was assessed 7 years post-injury and matched to controls.
- A subgroup of 20 participants had longitudinal data from 3 to 24 months post-TBI.
- Behavioral problems (internalizing, externalizing) were assessed using self- and parent reports (Achenbach's Behavioral Checklist).
Main Results:
- Children with severe TBI showed significantly higher rates of externalizing problems (self- and parent-reported) compared to controls.
- Specific issues included withdrawn/depressed behavior, intrusive behavior, somatic complaints (self-report), and rule-breaking, attention, and social problems (parent-report).
- Externalizing problems correlated with injury severity, disability, lower intellectual ability, and poorer family functioning; internalizing problems persisted over time.
Conclusions:
- Severe TBI in children is associated with a high prevalence of persistent behavioral problems, particularly externalizing issues.
- Factors such as injury severity and family functioning significantly predict externalizing behaviors.
- Long-term follow-up and individualized behavioral interventions are critical for this population.
Purpose/Objective:
To investigate the occurrence of behavioral problems 7 years after severe pediatric traumatic brain injury (TBI), and their evolution from 3 months to 7 years postinjury.
Method/Design:
Thirty-four participants, 38% girls, M (SD) age at injury 7.6 (4.7) years, age at assessment 15 (4.6) years, underwent comprehensive assessments 7 years after severe TBI from March 2014 to March 2016 and were matched to a control group by age, gender, and parental education. A subgroup of 20 participants had available behavioral assessments at 3, 12, and 24 months postinjury. Internalizing, externalizing, and total behavioral problems were assessed with self- and parent reports of the Achenbach's Behavioral Checklist. Additional data included sociodemographic background, initial injury severity, and specific outcomes assessed concurrently 7 years postinjury.
Results:
Compared to controls: (a) a significant proportion of participants with severe TBI fell above the clinical cutoff for self- (42%) and parent-reported (36%) externalizing problems, but not for self- (33%) or parent-reported (45%) internalizing problems; (b) withdrawn/depressed, intrusive behavior, and somatic complaints were significantly higher in self-reports; and (c) rule-breaking behavior, attention, and social problems were significantly higher in parent reports. Parent-reported internalizing problems were associated with older age at injury, whereas externalizing problems correlated with greater injury severity and concurrent levels of greater overall disability, lower intellectual ability, and poorer family functioning. In multiple hierarchical regression analyses, overall disability and worse family functioning significantly predicted externalizing problems. Parent-reported internalizing and externalizing problems persisted over time.
Conclusions/Implications:
These results highlight the importance of long-term follow-up and individualized behavioral interventions for children who sustained severe TBI. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
