Traumatic brain injury as a risk factor for behavioral disorders in children

The most common behavioral problems that are associated with traumatic brain injury in children are the same behaviors that prompt referral to special education for behavioral disorder. The purpose of this study was to determine whether there is an association between traumatic head injury in children and subsequent behavioral disorders for which special educational services are provided. A case-control design was used to compare occurrences of prior head injury in children receiving special educational services for behavioral disorders (cases) to similar occurrences in children in regular education (controls). Subjects included 170 case and 197 control students in grades 1 through 5 in a single large school district during 1988-1989. Data were collected by parent questionnaire and school record review. The odds ratio (OR) of a history of head injury among children with behavioral disorders relative to controls was 3.3 (95% confidence interval [CI] 1.3-8.3); the OR of a history of head injury sustained during the preschool years was 8.7 (95% CI 2.5-30.7) in cases relative to controls. Mean IQ scores were significantly lower for cases injured at two years of age or less in comparison with cases injured later. Full scale IQs (+/- SD) were 88 +/- 5 versus 107 +/- 14 (t = 3.5, p = .008), performance IQs 91 +/- 9 versus 108 +/- 12 (t = 3.0, p = .012), and verbal IQs 86 +/- 7 versus 106 +/- 15 (t = 3.2, p = .008). Achievement test results did not differ between cases with and those without histories of head injury.(ABSTRACT TRUNCATED AT 250 WORDS)