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Early Elementary School Outcome in Children With a History of Traumatic Brain Injury Before Age 6 Years

Haarbauer-Krupa, Juliet, PhD; King, Tricia Z., PhD; Wise, Justin, PhD; Gillam, Schauna, BS; Trapani, Julie, BS; Weissman, Barbara, MD; DePompei, Roberta, PhD

The Journal of Head Trauma Rehabilitation: March/April 2019 - Volume 34 - Issue 2 - p 111–121
doi: 10.1097/HTR.0000000000000414
Pediatric TBI 2019
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Objective: To describe elementary school outcomes for children who experienced a traumatic brain injury (TBI) before age 6 years compared with a control group of children with orthopedic injuries.

Participants: Children ages 6 to 9 years recruited from community and trauma registries in a large southeastern state.

Design: Descriptive findings from the first year of a 3-year longitudinal study.

Main Measures: Child assessment and parent report measures were administered to capture cognitive, language, reading, and behavior outcomes. Medical record review confirmed injuries and injury severity.

Results: The TBI group (n = 39) had a mean age of 7.55 years (standard deviation = 1.29) and was 5.15 (standard deviation = 1.56) years postinjury. The TBI group had primarily classified as mild complicated TBI (63%). On average, children in both groups performed within normal limits on most cognitive, language, and reading measures. Group differences were identified in verbal IQ, receptive language, and reading comprehension, with robust performance differences in pragmatic language, story retell and word fluency, and parent report of executive functions.

Conclusions: Findings indicate the importance of in-depth follow-up specialist assessments (eg, neuropsychologist and speech and language pathologists) to identify potential nuanced difficulties in children with mild complicated TBI that may be missed by general evaluations.

Department of Pediatrics (Drs Haarbauer-Krupa and Weissman) and Children's Center for Neuroscience Research Georgia (Dr Weissman), Emory University School of Medicine, Atlanta, Georgia; Children's Healthcare of Atlanta, Atlanta, Georgia (Drs Haarbauer-Krupa and Weissman and Mss Gillam and Trapani); Department of Psychology and the Neuroscience Institute, Georgia State University, Atlanta, Georgia (Dr King); Department of Psychology, Oglethorpe University, Atlanta, Georgia (Drs Wise); and School of Speech-Language Pathology, University of Akron, Ohio (Dr DePompei).

Corresponding Author: Juliet Haarbauer-Krupa, PhD, Department of Pediatrics, Emory University School of Medicine, 3172 Wicks Creek Trail, Marietta, GA 30062 (jhkrupa@me.com).

We acknowledge and appreciate the contribution of Cassandra Hendrix, Kristen Smith, and Joanna Beugnon who helped with data collection, scoring, and data entry throughout the study. We are grateful to the families who participated in this research.

This study is sponsored by a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (Formerly the National Institute National Institute on Disability and Rehabilitation Research), grant number H133G110109.

The authors declare no conflicts of interest.

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.