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Long-Term School Outcomes of Children and Adolescents With Traumatic Brain Injury

Prasad, Mary R. PhD; Swank, Paul R. PhD; Ewing-Cobbs, Linda PhD

The Journal of Head Trauma Rehabilitation: January/February 2017 - Volume 32 - Issue 1 - p E24–E32
doi: 10.1097/HTR.0000000000000218
Focus on Clinical Research and Practice

Objective: To better understand the impact of age at injury, severity of injury, and time since injury on long-term school outcomes of children with traumatic brain injury (TBI).

Participants: Four groups of children: complicated mild/moderate TBI (n = 23), severe TBI (n = 56), orthopedic injury (n = 35), and healthy controls (n = 42). Children with TBI were either 2 years postinjury or 6 years postinjury.

Design: Cross-sectional design.

Measures: School records as well as parental ratings of functional academic skills and school competency.

Results: Children with severe TBI had consistently high usage of school services and low school competency ratings than children with orthopedic injuries and healthy controls. In contrast, children with complicated-mild/moderate TBI were significantly more likely to receive school support services and have lower competence ratings at 6 years than at 2 years postinjury. Students injured at younger ages had lower functional academic skill ratings than those injured at older ages.

Conclusions: These findings highlight the increasing academic challenges faced over time by students with complicated-mild/moderate TBI and the vulnerability of younger children to poorer development of functional academic skills.

Supplemental Digital Content is Available in the Text.

Children's Learning Institute, UT Health, Houston, Texas (Drs Prasad and Ewing-Cobbs); and School of Public Health, UT Health, Houston, Texas (Dr Swank).

Corresponding Author: Mary R. Prasad, PhD, Children's Learning Institute, UT Health, 7000 Fannin, Houston, TX 77030 (

This manuscript was supported by grant number R01NS046308 from the National Institute of Neurological Disorders and Stroke to Dr Linda Ewing-Cobbs. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Neurological Disorders and Stroke or the National Institutes of Health.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

The authors declare no conflicts of interest.

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