Intra-individual variability in recovery from paediatric acquired brain injury: relationship to outcomes at 1 year.
OBJECTIVE
To determine the relationship between the amount of intra-individual variability in measures of abilities and participation throughout the first 8 months of recovery from ABI and outcome scores at 1 year. Greater amounts of intra-individual variability throughout recovery are hypothesized to predict better outcome scores at 1 year.


METHODS
This is a secondary data analysis of a longitudinal cohort study.


METHODS
Eighty-seven children and youths were assessed with self and proxy report measures of child functioning, family functioning and environmental factors at regular intervals after ABI. Mixed-effects modelling was used to determine individual linear recovery trajectories. Intra-individual variability was defined as the intra-individual standard deviation of the residuals around the recovery line.


RESULTS
Less intra-individual variability in recovery predicts better outcomes of physical health (Child Health Questionnaire), behavioural functioning (Strengths and Difficulties Questionnaire), family coping (Impact on Family Scale) and impact of environmental barriers (Craig Hospital Inventory of Environmental Factors). As amount of intra-individual variability increases, outcomes become poorer.


CONCLUSIONS
Findings support the existence of intra-individual variability in instrument scores over time in this sample and the impact of this variability on several outcomes at 1 year. Potential clinical and research implications are discussed.
Levac
Danielle
D
Rehabilitation Science, Institute for Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada. levacde@mcmaster.ca
DeMatteo
Carol
C
Hanna
Steven
S
Wishart
Laurie
L
D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior; D000704:Analysis of Variance; D001930:Brain Injuries / Q000175:diagnosis* / Q000209:etiology / Q000534:rehabilitation*; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D015331:Cohort Studies; D003266:Continuity of Patient Care; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D009483:Neuropsychological Tests; D015588:Observer Variation; D010555:Personality Inventory; D011336:Probability; D011788:Quality of Life; D020127:Recovery of Function; D018570:Risk Assessment; D018434:Sickness Impact Profile; D012917:Social Adjustment; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome