Research Article

Traumatic brain injury in young children: Postacute effects on cognitive and school readiness skills

H. GERRY TAYLOR^a1 c1, MAEGAN D. SWARTWOUT^a2, KEITH OWEN YEATES^a3, NICOLAY CHERTKOFF WALZ^a4, TERRY STANCIN^a5 and SHARI L. WADE^a6

^a1 Division of Developmental and Behavioral Pediatrics and Pediatric Psychology, Department of Pediatrics, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio

^a2 Department of Psychology, University of Houston, Houston, Texas

^a3 Division of Psychology, Department of Pediatrics, The Ohio State University & Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio

^a4 Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio

^a5 Division of Pediatric Psychology, Department of Pediatrics, MetroHealth Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio

^a6 Department of Rehabilitation, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio

Abstract

Previous studies have documented weaknesses in cognitive ability and early academic readiness in young children with traumatic brain injury (TBI). However, few of these studies have rigorously controlled for demographic characteristics, examined the effects of TBI severity on a wide range of skills, or explored moderating influences of environmental factors on outcomes. To meet these objectives, each of three groups of children with TBI (20 with severe, 64 with moderate, and 15 with mild) were compared with a group of 117 children with orthopedic injuries (OI group). The children were hospitalized for their injuries between 3 and 6 years of age and were assessed an average of 1½ months post injury. Analysis revealed generalized weaknesses in cognitive and school readiness skills in the severe TBI group and less pervasive effects of moderate TBI. Indices of TBI severity predicted outcomes within the TBI sample and environmental factors moderated the effects of TBI on some measures. The findings document adverse effects of TBI in early childhood on postacute cognitive and school readiness skills and indicate that these effects are related to both injury severity and the family environment. (JINS, 2008, 14, 734–745.)

(Received March 25 2008)

(Revised June 12 2008)

(Accepted June 13 2008)

KEYWORDS

• Child;
• Preschool;
• Brain injuries;
• Neurobehavior manifestations;
• Outcome;
• Moderator variables

Correspondence:

^c1 Correspondence and reprint requests to: H. Gerry Taylor, Division of Developmental/Behavioral Pediatrics and Psychology, D.O. Walker Building, Suite 3150, 10524 Euclid Avenue, Cleveland, OH. E-mail: hgt2@case.edu