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Do Children Who Sustain Traumatic Brain Injury in Early Childhood Need and Receive Academic Services 7 Years After Injury?

Kingery, Kathleen M. MA*; Narad, Megan E. PhD*; Taylor, H. Gerry PhD; Yeates, Keith Owen PhD; Stancin, Terry PhD§; Wade, Shari L. PhD*

Journal of Developmental & Behavioral Pediatrics: November/December 2017 - Volume 38 - Issue 9 - p 728–735
doi: 10.1097/DBP.0000000000000489
Original Articles
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Objective: To examine the prevalence of academic need, academic service utilization, and unmet need as well as factors associated with academic service utilization 6.8 years after traumatic brain injury (TBI) in early childhood.

Methods: Fifty-eight (16 severe, 14 moderate, 28 complicated mild) children with TBI and 72 children with orthopedic injury (OI) completed the long-term follow-up 6.8 years after injury in early childhood (ages 3–7 years). Injury group differences in rates of need for academic services, academic service utilization, and unmet need as well as factors associated with service utilization and unmet need were examined.

Results: Students with moderate and severe TBI had significantly greater rates of need than those with OI. A greater proportion of the severe TBI sample was receiving academic services at long-term follow-up than the OI and complicated mild groups however, among those with an identified need, injury group did not affect academic service utilization. Below average IQ/achievement scores was the only area of need predictive of academic service utilization. Rates of unmet need were high and similar across injury groups (46.2%–63.6%).

Conclusion: The need for academic services among patients who sustained a TBI during early childhood remains high 6.8 years post injury. Findings underscore the importance of continued monitoring of behaviors and academic performance in students with a history of early childhood TBI. This may be especially true among children with less severe injuries who are at risk for being underserved.

*Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH;

Department of Pediatrics, Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH;

Department of Psychology, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada;

§MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH.

Address for reprints: Megan E. Narad, PhD, Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 3015, Cincinnati, OH 45229; e-mail: megan.narad@cchmc.org.

This project was supported by the National Institute of Child Health and Human Development (R01 HD42729 K02 HD44099), United States Public Health Service National Institutes of Health (M01 RR 08084), State of Ohio Emergency Medical Services trauma research grants, National Center for Research Resources and the National Center for Advancing Translational Sciences, and National Institutes of Health (8 UL1 TR000077-04 and K12 HD001097-16).

Disclosure: The authors declare no conflict of interest.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

See the video abstract at jdbp.org.

Received November , 2016

Accepted June , 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.