Abstract
Background: Increasing evidence suggests potential lifetime effects following mild traumatic brain injury (TBI) in childhood. Few studies have examined medium-term outcomes among hospitalized and non-hospitalized samples. Study aims were to describe children's behavioral and emotional adjustment, executive function (EF), quality of life, and participation at 7-years following mild TBI using parents' and teachers' reports.Methods: Nested case control study of 86 children (68% male, mean age at assessment = 11.27 years; range 7–17 years) who sustained a mild TBI 7-years previously, identified from a prospective, population-based study. They were compared to 69 children free from TBI (61% male, mean age at assessment = 11.12 years; range 5–17 years). In addition to parent-reported socio-demographic details, parents (mild TBI n = 86, non-TBI n = 69) completed age-appropriate standardized questionnaires about children's health-related quality of life, behavioral and emotional adjustment, EF, and social participation. Parents own mood was assessed using the Hospital Anxiety and Depression Scale. Teachers (mild TBI n = 53, non-TBI n = 42) completed questionnaires about children's behavioral and emotional adjustment, and EF.Results: Parent reports showed median group-level scores for cases were statistically significantly greater than controls for emotional symptoms, conduct problems, hyperactivity/inattention, total behavioral difficulties, inhibitory control, shifting, planning/organizing, and Global Executive Composite (total) EF difficulties (p-values 0.001–0.029). Parent reports of child quality of life and social participation were similar, as were teacher reports of child behavioral and emotional adjustment, and EF (p > 0.05). When examining clinical cut-offs, compared to controls, cases had a higher risk of parent-reported total EF difficulties (odds ratio = 3.00) and, to a lesser extent, total behavior problems (odds ratio = 2.51).Conclusions: As a group, children with a history of mild TBI may be at elevated risk for clinically significant everyday EF difficulties in the medium-term compared to non-TBI controls, as judged by their parents. Further multi-informant longitudinal research is required, following larger samples. Aspects requiring particular attention include pre-injury characteristics, such as sleep disturbances and comorbidities (e.g., headaches), that may act as potential confounders influencing the association between mild TBI and child behavioral problems.
Highlights
Growing evidence from birth cohort studies suggests prospective links between a history of mild traumatic brain injury (TBI) in childhood and a range of risky behaviors later in life [1,2,3]
Children with mild TBI who were included in the current analysis (n = 86) were compared to those from the BIONIC study cohort that had a mild TBI but who were not included (n = 342)
The main finding of our nested case control study was that children with a history of mild TBI are more likely to be characterized by behavioral and emotional adjustment problems and executive function (EF) difficulties in the home setting
Summary
Growing evidence from birth cohort studies suggests prospective links between a history of mild traumatic brain injury (TBI) in childhood and a range of risky behaviors later in life [1,2,3]. These include increased risks for substance use, disruptive behavior disorders, conduct problems, and criminal behavior. Growing evidence of associations between mild TBI in childhood and adverse long-term outcomes later in life raise questions about whether or not it is possible to detect indicators of maladjustment and difficulties in the medium-term following mild TBI. Study aims were to describe children’s behavioral and emotional adjustment, executive function (EF), quality of life, and participation at 7-years following mild TBI using parents’ and teachers’ reports
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
