Research Reports - Long-term neuropsychological profiles and their role as mediators of adaptive functioning after traumatic brain injury in early childhood

J Neurotrauma. 2017 Jan 15;34(2):353-362. doi: 10.1089/neu.2016.4476. Epub 2016
May 9.

Treble-Barna A(1), Zang H(2), Zhang N(2), Taylor HG(3), Yeates KO(4), Wade S(1).

The objectives of the study were to characterize long-term neuropsychological
outcomes following traumatic brain injury (TBI) sustained during early childhood,
and determine whether identified neuropsychological impairments mediated the
effect of TBI on long-term adaptive functioning. Participants included 16
children with severe TBI, 42 children with moderate TBI, and 72 children with
orthopedic injuries (OI) sustained between ages 3 and 7 years. Children completed
neuropsychological tests and caregivers completed a structured interview of child
adaptive functioning at 6.9 (±1.10) years post-injury. Profile analysis and
multiple mediator modeling were employed. Children with severe TBI demonstrated
poorer fluid reasoning and inhibitory control than both children with moderate
TBI and OI, as well as slower processing speed than the OI group. Both fluid
reasoning and processing speed were significant independent mediators of the
effect of severe TBI on adaptive functioning. No neuropsychological measure
significantly mediated the effect of moderate TBI on adaptive functioning.
Children sustaining early severe TBI demonstrate persisting neuropsychological
impairments into adolescence and young adulthood. The impact of severe TBI on
children's long-term adaptive functioning is mediated in part by its effects on
fluid reasoning and processing speed.

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