A randomized problem-solving trial for adolescent brain injury: Changes in social competence.
Traumatic brain injury (TBI) in adolescence has well documented effects on social competence. Few studies have examined the effects of behavioral interventions on social competence or identified factors associated with changes in social competence after injury. Research Method/Design: Adolescents with moderate to severe TBI ages 12-17 years were randomized within 6 months of injury to either a problem solving and communication (CAPS) group that received online counseling (n = 65) or an Internet resources comparison (IRC) group (n = 67) for a comparative effectiveness trial. Parent-report measures of social competence (Child Behavior Checklist, CBCL; Home and Community Social Behavior Scales, HCSBS; Behavioral and Emotional Rating Scale, BERS-2) were administered at baseline (preintervention) and approximately 6 months later. Analyses examined these measures in relation to treatment group, TBI severity, and age. Regression analyses were also conducted to examine baseline measures of cognition as predictors of social competence after TBI.



CAPS had a more positive effect than the comparison condition on the HCSBS and BERS-2 for younger teens with moderate TBI and older teens with severe TBI. More parent-rated executive dysfunction at baseline was related to both lower concurrent levels of social competence and less positive gains in competence over time, whereas higher baseline IQ predicted greater gains in competence.



CAPS may be effective for improving social competence for teens after TBI, with benefits dependent on the teen's age and injury severity. Parent-rated executive dysfunction, moreover, has utility in predicting both lower concurrent levels of social competence and subsequent postinjury gains in competence. (PsycINFO Database Record
Department of Physical Medicine and Rehabilitation, Children's Hospital Colorado.
Sarah J
SJ
Tlustos
Department of Physical Medicine and Rehabilitation, Children's Hospital Colorado.
Michael W
MW
Kirkwood
Division of Developmental and Behavioral Pediatrics and Psychology, Department of Pediatrics, Case Western Reserve University.
H Gerry
HG
Taylor
Division of Pediatric Psychology, Department of Pediatrics, MetroHealth Medical Center.
Terry
T
Stancin
Department of Psychology, Mayo College of Medicine.
Tanya M
TM
Brown
Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children's Hospital Medical Center.
Shari L
SL
Wade
D000293:Adolescent; D000070642:Brain Injuries, Traumatic / Q000523:psychology* / Q000534:rehabilitation*; D057189:Checklist; D003142:Communication; D057186:Comparative Effectiveness Research; D056344:Executive Function; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010552:Personality Assessment; D011340:Problem Solving; D066107:Social Skills; D013813:Therapy, Computer-Assisted; D014888:Wechsler Scales