Research Reports - Age at injury and long-term behavior problems after traumatic brain injury in young children

Rehabil Psychol. 2012 Aug;57(3):256-65

Karver CL, Wade SL, Cassedy A, Taylor HG, Stancin T, Yeates KO, Walz NC

Objective: This study examined the effects of age at injury on the persistence of
behavior problems and social skill deficits in young children with complicated
mild to severe traumatic brain injury (TBI). Method: A concurrent
cohort/prospective research design was used with repeated assessments of children
with TBI (n = 82) or Orthopedic Injury (OI) (n = 114). Parents completed the
Child Behavior Checklist, the Behavior Rating Inventory of Executive Functions,
and the Preschool and Kindergarten Behavior Scales or the Home and Community
Social and Behavior Scales shortly after injury to assess preinjury functioning,
and at an extended follow-up an average of 38 months postinjury. Generalized
linear modeling was used to examine the relationship of age at injury to the
maintenance of behavior problems, and logistic regression was used to examine the
persistence of clinically significant behavior problems. Results: At the extended
follow-up, severe TBI was associated with significantly greater anxiety problems
relative to the Group OI. With increasing time since injury, children who
sustained a severe TBI at an earlier age had significantly higher levels of
parent-reported symptoms of ADHD and anxiety than children who were older at
injury. Conclusions: Findings suggest that longer-term treatment for behavior
problems may be needed after severe TBI, particularly for those injured at an
earlier age.

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