title: Adaptive ability, behavior and quality of life pre and posttraumatic brain injury in childhood.
abstract: BACKGROUND
  Traumatic brain injury (TBI) is a common, acquired childhood disability, which has been shown to have a significant impact on children's cognitive and educational function. While behavioral problems are also noted, there is ongoing debate about the contribution of preinjury factors in this domain. Few studies have attempted to measure the impact of these preinjury functions on postinjury behavior.
  
  
  OBJECTIVE
  To compare pre and postinjury adaptive ability, behavior, executive function and quality of life (QOL) and to identify factors that contribute to outcomes in these domains including injury severity, socio-demographic and preinjury characteristics.
  
  
  METHODS
  Consecutive recruitments to a prospective, longitudinal study, utilizing a between factor design, with injury severity as the independent variable.
  
  
  METHODS
  Children admitted to hospital with a diagnosis of TBI aged between 6 and 14 years (n = 205) were divided according to injury severity (mild, moderate and severe). Adaptive behavior (Vineland Adaptive Behavior Scales), child behavior (Child Behavior Checklist), everyday executive functions (Behavior Rating Inventory of Executive Function) and QOL (Child Health Questionnaire) assessed at 6 months post-TBI.
  
  
  CONCLUSIONS
  Severity by time interactions were identified across a range of outcome domains demonstrating that more severe injury is associated with a decrease in functional ability at 6 months post-TBI. This effect was most pronounced for everyday executive skills, social function and internalizing aspects of child behavior. Preinjury function was a consistent predictor of postinjury status. Injury severity contributed little to the prediction of functional outcomes once preinjury functioning was accounted for in the model. Age at injury and family cohesion were relevant to specific outcome domains only. Socio-economic status did not contribute significantly to outcome at 6 months. Preinjury functioning as reported by parents in the acute phase may be a useful predictive tool for identifying children who may be at risk of functioning difficulties 6 months post-TBI.
authors.affiliation: Critical Care & Neuroscience, Murdoch Childrens Research Institute, Melbourne, Australia. vicki.anderson@rch.org.au
authors.forename: Vicki
authors.initials: V
authors.lastname: Anderson
authors.forename: Robyne
authors.initials: R
authors.lastname: Le Brocque
authors.forename: Greg
authors.initials: G
authors.lastname: Iselin
authors.forename: Senem
authors.initials: S
authors.lastname: Eren
authors.forename: Rian
authors.initials: R
authors.lastname: Dob
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Davern
authors.forename: Lynne
authors.initials: L
authors.lastname: McKinlay
authors.forename: Justin
authors.initials: J
authors.lastname: Kenardy
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000293:Adolescent; D001930:Brain Injuries / Q000175:diagnosis* / Q000523:psychology; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000523:psychology; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation; D004185:Disability Evaluation; D056344:Executive Function; D005195:Family Relations; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D018434:Sickness Impact Profile; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D015599:Trauma Severity Indices