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Family functioning and children's academic performance and behavior problems in the year following traumatic brain
J B Rivara1, K M Jaffe, N L Polissar
1Department of Rehabilitation Medicine, Children's Hospital and Medical Center, Seattle, WA.
Insights
Preinjury factors significantly impact outcomes after childhood traumatic brain injury (TBI). While injury severity affects academic performance, preinjury functioning is key for behavioral health following TBI.
Area of Science:
- Pediatric Neurosciences
- Child Psychology
- Rehabilitation Medicine
Background:
- Childhood traumatic brain injury (TBI) presents complex challenges impacting development.
- Understanding predictive factors for TBI outcomes is crucial for effective intervention.
- Previous research highlights the importance of both injury characteristics and individual factors.
Purpose of the Study:
- To investigate the predictive roles of preinjury family and child functioning, and injury severity on 1-year academic and behavioral outcomes after childhood TBI.
- To analyze changes in academic performance and behavioral problems post-TBI across different injury severities.
- To identify key factors influencing long-term recovery in children with TBI.
Main Methods:
- Longitudinal study of 94 children (ages 6-15) with mild, moderate, or severe TBI.
- Data collection included standardized measures of family and child functioning at preinjury, 3 months, and 1 year post-injury.
- Interviewer ratings assessed functioning and behavioral changes over the study period.
Main Results:
- Injury severity correlated with significant academic functioning declines.
- No significant association was found between injury severity and changes in behavioral problems.
- Preinjury child and family functioning were strong predictors of behavioral outcomes, while injury severity and preinjury factors predicted academic/cognitive outcomes.
- Functioning declined across all injury severity levels.
Conclusions:
- Preinjury functioning is a critical determinant of behavioral outcomes following childhood TBI.
- Academic and cognitive outcomes are influenced by both injury severity and preinjury functioning.
- Early assessment of preinjury functioning and provision of support services are essential for optimizing recovery in children with TBI.
Abstract:
This study examined the roles of preinjury family and child functioning and injury severity in predicting 1-year outcomes and changes in academic performance and behavioral problems following childhood traumatic brain injury (TBI). Families of 94 children (ages 6 to 15) with TBI (mild = 50, moderate = 25, severe = 19) were consecutively enrolled from emergency departments of two regional medical centers. Standardized measures of family and child functioning and interviewer ratings were completed within 3 weeks of injury (measuring preinjury status), at 3 months, and 1 year. Mean ratings of preinjury child functioning were within normal range. Whereas injury severity was associated with substantial declines in academic functioning, there was no association of injury severity with change in behavior problems. Interview ratings showed declines at all severity levels, however. Poor academic and cognitive outcomes at 1 year were associated with injury severity and, to a lesser degree, poor preinjury family and child functioning. In contrast, most of the variation in behavioral outcomes was explained by preinjury child or family factors. Preinjury functioning must be assessed and support services provided for optimal academic and behavioral outcomes following childhood TBI.