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Updated: Jul 20, 2026
Controlled Cortical Impact Model for Traumatic Brain Injury
Published on: August 5, 2014
Adaptive functioning following traumatic brain injury and orthopedic injury: a controlled study
J E Max1, S L Koele, S D Lindgren
1Department of Psychiatry, University of Iowa, Iowa City 52242, USA.
Objective:
To study adaptive functioning after severe traumatic brain injury (TBI).
Design:
Case-control study.
Setting:
A university hospital and three regional and four community hospitals.
Subjects:
A consecutive series (n=24) of children age 5 through 14 years who suffered severe TBI were individually matched to subjects who sustained a mild TBI and to a second group who sustained an orthopedic injury with no evidence of TBI.
Main Outcome Measures:
Standardized adaptive functioning, intellectual, psychiatric, and neuroimaging assessments were conducted on average 2 years after injury.
Results:
Severe TBI was associated with significantly (p < .05) lower Vineland Adaptive Behavior composite, communication, and socialization standard scores and lower Child Behavior Checklist parent-rated social competence scores compared with children with orthopedic injury. Severe TBI and mild TBI subjects were significantly (p < .05) more impaired than orthopedic subjects on teacher-rated adaptive function. Family functioning, psychiatric disorder in the child, and IQ were significant variables, explaining between 22% and 47% of the variance in adaptive functioning outcomes.
Conclusions:
Severe TBI is associated with significant deficits in child adaptive functioning. This association appears to be mediated by family dysfunction, child psychiatric disorder, and intellectual deficits.
