Adaptive functioning following traumatic brain injury and orthopedic injury: a controlled study.
OBJECTIVE
To study adaptive functioning after severe traumatic brain injury (TBI).


METHODS
Case-control study.


METHODS
A university hospital and three regional and four community hospitals.


METHODS
A consecutive series (n=24) of children age 5 through 14 years who suffered severe TBI were individually matched to subjects who sustained a mild TBI and to a second group who sustained an orthopedic injury with no evidence of TBI.


METHODS
Standardized adaptive functioning, intellectual, psychiatric, and neuroimaging assessments were conducted on average 2 years after injury.


RESULTS
Severe TBI was associated with significantly (p < .05) lower Vineland Adaptive Behavior composite, communication, and socialization standard scores and lower Child Behavior Checklist parent-rated social competence scores compared with children with orthopedic injury. Severe TBI and mild TBI subjects were significantly (p < .05) more impaired than orthopedic subjects on teacher-rated adaptive function. Family functioning, psychiatric disorder in the child, and IQ were significant variables, explaining between 22% and 47% of the variance in adaptive functioning outcomes.


CONCLUSIONS
Severe TBI is associated with significant deficits in child adaptive functioning. This association appears to be mediated by family dysfunction, child psychiatric disorder, and intellectual deficits.
Max
J E
JE
Department of Psychiatry, University of Iowa, Iowa City 52242, USA.
Koele
S L
SL
Lindgren
S D
SD
Robin
D A
DA
Smith
W L
WL
Sato
Y
Y
Arndt
S
S
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000293:Adolescent; D001842:Bone and Bones / Q000293:injuries; D001930:Brain Injuries / Q000503:physiopathology / Q000523:psychology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003142:Communication; D005190:Family / Q000523:psychology; D006801:Humans; D007361:Intelligence Tests; D011569:Psychiatric Status Rating Scales; D012919:Social Behavior; D011795:Surveys and Questionnaires