title: Utilization of behavioral therapy services long-term after traumatic brain injury in young children.
abstract: OBJECTIVE
  To examine associations of clinical need, defined by elevated parent ratings of child behavior problems and utilization of behavioral health services in young children with traumatic brain injury (TBI) and an orthopedic injury (OI) comparison group.
  
  
  METHODS
  Parents completed outcome measures 18 months after injury and at an extended follow-up conducted an average of 38 months postinjury.
  
  
  METHODS
  Children's hospitals and a general hospital.
  
  
  METHODS
  Participants included parents of 3 groups of children injured between 3 and 7 years of age (N=139): 47 children with complicated mild to moderate TBI, 18 with severe TBI, and 74 with OI.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Parents completed ratings of child behavior, mental health symptomology, and family functioning at both visits; at the extended follow-up, they reported utilization of behavior therapy or counseling services since the 18-month follow-up visit.
  
  
  RESULTS
  Children with TBI had more behavior problems than those with OI. Although clinical need at both follow-ups was associated with greater service utilization at the extended follow-up, all groups had unmet needs as defined by a clinical need in the absence of services. Lower socioeconomic status was associated with higher rates of unmet need across groups.
  
  
  CONCLUSIONS
  The results document unmet long-term behavioral health needs after both TBI and OI in children and underscore the importance of monitoring and treatment of postinjury behavior problems.
authors.affiliation: Department of Psychology, University of Cincinnati, Cincinnati, OH; Department of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital, Cincinnati, OH. Electronic address: karvercl@mail.uc.edu.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Karver
authors.affiliation: Department of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital, Cincinnati, OH.
authors.forename: Brad
authors.initials: B
authors.lastname: Kurowski
authors.affiliation: College of Medicine, University of Toledo, Toledo, OH.
authors.forename: Erin A
authors.initials: EA
authors.lastname: Semple
authors.affiliation: Department of Psychiatry, Case Western Reserve University and MetroHealth Medical Center, Cleveland, OH.
authors.forename: Terry
authors.initials: T
authors.lastname: Stancin
authors.affiliation: Case Western Reserve University/University Hospitals, Cleveland, OH.
authors.forename: H Gerry
authors.initials: HG
authors.lastname: Taylor
authors.affiliation: Ohio State University/Nationwide Children's Hospital, Columbus, OH.
authors.forename: Keith O
authors.initials: KO
authors.lastname: Yeates
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Nicolay C
authors.initials: NC
authors.lastname: Walz
authors.affiliation: Department of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital, Cincinnati, OH; College of Medicine, University of Cincinnati, Cincinnati, OH.
authors.forename: Shari L
authors.initials: SL
authors.lastname: Wade
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000209:etiology / Q000628:therapy*; D001521:Behavior Therapy; D001930:Brain Injuries / Q000150:complications / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D003376:Counseling / Q000706:statistics & numerical data*; D005190:Family / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D009141:Musculoskeletal System / Q000293:injuries; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012923:Social Class; D013997:Time Factors
keywords: Behavior therapy; Brain injuries; Rehabilitation
references.citation: J Am Acad Child Adolesc Psychiatry. 2002 Feb;41(2):148-56
references.pmid: 11837404
references.citation: Arch Phys Med Rehabil. 2004 Sep;85(9):1428-34
references.pmid: 15375812
references.citation: J Head Trauma Rehabil. 2002 Apr;17(2):96-111
references.pmid: 11909509
references.citation: Annu Rev Psychol. 2002;53:371-99
references.pmid: 11752490
references.citation: J Neurotrauma. 2010 Aug;27(8):1529-40
references.pmid: 20504161
references.citation: Lancet. 1974 Jul 13;2(7872):81-4
references.pmid: 4136544
references.citation: J Trauma. 1974 Mar;14(3):187-96
references.pmid: 4814394
references.citation: J Neurotrauma. 2012 Jan 1;29(1):143-53
references.pmid: 22022835
references.citation: Rehabil Psychol. 2012 Aug;57(3):256-65
references.pmid: 22946613
references.citation: J Head Trauma Rehabil. 2008 Jul-Aug;23(4):197-208
references.pmid: 18650764
references.citation: Lancet Neurol. 2013 Jan;12(1):53-64
references.pmid: 23177532
references.citation: J Head Trauma Rehabil. 2005 May-Jun;20(3):229-38
references.pmid: 15908823
references.citation: Pediatrics. 2006 Apr;117(4):e663-74
references.pmid: 16533894
references.citation: J Pediatr Psychol. 2008 Aug;33(7):707-18
references.pmid: 18296728
references.citation: J Am Acad Child Adolesc Psychiatry. 2001 May;40(5):572-9
references.pmid: 11349702
references.citation: J Dev Behav Pediatr. 2010 May;31(4):317-25
references.pmid: 20431399
references.citation: J Consult Clin Psychol. 1997 Jun;65(3):453-63
references.pmid: 9170769
references.citation: Brain Inj. 2000 May;14(5):417-29
references.pmid: 10834337
references.citation: Depress Anxiety. 2008;25(5):398-407
references.pmid: 17957806
references.citation: Pediatrics. 2011 Nov;128(5):970-9
references.pmid: 22025589
references.citation: Brain Inj. 2000 Jun;14(6):495-503
references.pmid: 10887884
references.citation: Arch Clin Neuropsychol. 2005 Aug;20(6):675-95
references.pmid: 15967630
references.citation: Arch Gen Psychiatry. 2005 Jun;62(6):629-40
references.pmid: 15939840
references.citation: Rehabil Psychol. 2010 Feb;55(1):48-57
references.pmid: 20175634
references.citation: J Nerv Ment Dis. 1998 Jun;186(6):325-32
references.pmid: 9653415
references.citation: J Pediatr Psychol. 2010 Aug;35(7):716-27
references.pmid: 19995865
references.citation: J Pediatr Psychol. 2003 Jun;28(4):251-63
references.pmid: 12730282
references.citation: J Neurotrauma. 2012 Nov 1;29(16):2539-47
references.pmid: 22846066
references.citation: Neuropsychology. 2002 Oct;16(4):514-23
references.pmid: 12382990
references.citation: PM R. 2011 Sep;3(9):836-45
references.pmid: 21944301
references.citation: Pediatrics. 1998 Jul;102(1 Pt 1):110-6
references.pmid: 9651422
references.citation: J Neurol Neurosurg Psychiatry. 2002 Sep;73(3):281-8
references.pmid: 12185159
references.citation: J Clin Child Psychol. 1999 Jun;28(2):232-43
references.pmid: 10353082
references.citation: J Int Neuropsychol Soc. 2001 Sep;7(6):755-67
references.pmid: 11575597
references.citation: Brain Inj. 2004 Aug;18(8):751-64
references.pmid: 15204316
references.citation: J Fam Psychol. 2004 Mar;18(1):19-35
references.pmid: 14992607
references.citation: J Nerv Ment Dis. 1998 Oct;186(10):589-96
references.pmid: 9788634