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Predicting Longitudinal Patterns of Functional Deficits in Children With Traumatic Brain Injury

Posted Jun 04 2009 10:32pm

Childhood traumatic brain injury (TBI) has long been associatied with academic, functional, and cognitive problems in school-age children. A study published in the May issue of Neuropsychology looked into longitudinal patterns of functional deficits in 37 children with severe traumatic brain injury (Glasgow Coma Scale score less than 8), 40 children with moderate TBI (Score of 9 to 12 without complications), and 44 children with orthopedic injuries. The injuries occurred between the ages of 6 to 12 years of age. The children in the study underwent neuropsychological, behavioral, adaptive, and academic testing at 6 months, 12 months, and 3–5 years postinjury. Functional deficits (<10th percentile for age) were identified within each outcome domain at each occasion. Children were classified into 4  longitudinal patterns of outcomes within domains (i.e., no deficits, improvement, deterioration, persistent deficits). Statistical analyses showed that severe TBI predicted an increased likelihood of persistent deficits in all outcome domains, as well as deterioration in behavioral functioning and improvement in neuropsychological, adaptive, and academic functioning. Severe TBI also predicted a greater total number of functional deficits across domains at each occasion. However, many children with severe TBI showed no deficits from 6 months to 4 years postinjury in 1 or more outcome domains. Duration of unconsciousness and lowest Glasgow Coma scores were significant predictors of range and extent of deficits. The findings help clarify the course of recovery for individual children following TBI.

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