Research Reports - Home environment as a predictor of long-term executive functioning following early childhood traumatic brain injury

J Int Neuropsychol Soc. 2017 Jul 20:1-11. doi: 10.1017/S1355617717000595. [Epub
ahead of print]

Durish CL(1), Yeates KO(2), Stancin T(3), Taylor HG(4), Walz NC(5), Wade SL(6).

OBJECTIVES: This study examined the relationship of the home environment to
long-term executive functioning (EF) following early childhood traumatic brain
injury (TBI).
METHODS: Participants (N=134) were drawn from a larger parent study of 3- to
6-year-old children hospitalized for severe TBI (n=16), complicated mild/moderate
TBI (n=44), or orthopedic injury (OI; n=74), recruited prospectively at four
tertiary care hospitals in the United States and followed for an average of 6.8
years post-injury. Quality of the home environment, caregiver psychological
distress, and general family functioning were assessed shortly after injury
(i.e., early home) and again at follow-up (i.e., late home). Participants
completed several performance-based measures of EF at follow-up. Hierarchical
regression analyses examined the early and late home environment measures as
predictors of EF, both as main effects and as moderators of group differences.
RESULTS: The early and late home environment were inconsistent predictors of
long-term EF across groups. Group differences in EF were significant for only the
TEA-Ch Walk/Don't Walk subtest, with poorer performance in the severe TBI group.
However, several significant interactions suggested that the home environment
moderated group differences in EF, particularly after complicated mild/moderate
TBI.
CONCLUSIONS: The home environment is not a consistent predictor of long-term EF
in children with early TBI and OI, but may moderate the effects of TBI on EF. The
findings suggest that interventions designed to improve the quality of
stimulation in children's home environments might reduce the long-term effects of
early childhood TBI on EF. 

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