Changing Healthcare and School Needs in the First Year After Traumatic Brain Injury.
Heather T Keenan, Amy E Clark, Richard Holubkov and 1 others
PMID 31246877WHAT IT FOUND
Unmet or unrecognized health care needs were 22% at 3 months, with 13% unrecognized and 7% unmet at 12 months.
Needs shifted from physical to cognitive and socioemotional, and combined health care or school need was 28% at 3 months and 24% at 12 months.
Key findings
01Unmet or unrecognized health care needs occurred in 22% of children at three months (14% unmet, 8% unrecognized); at 12 months, 13% had unrecognized and 7% had unmet needs.
02Needs shifted over time: among unmet health care needs at three months, 79% were physical, while at 12 months, 68% were socioemotional and 47% cognitive.
03The most common reason for unmet school needs was that the school did not recommend or provide the service at three months (24%) and 12 months (56%).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Needs were based on parent report, which may undercount health care visits or school supports. Unmet need was defined by parent report and may differ from what providers or schools would identify. Parents may have been unaware of informal school accommodations, such as extra time for exams or note taking. Families who completed all assessments were more likely to be non-Hispanic Caucasian and from Utah, so attrition may have biased the follow-up sample. Children with developmental delay or a psychiatric diagnosis requiring a closed classroom were excluded, so results may not apply to those children. Home-schooled children were excluded from school outcomes. It did not test an intervention, so it cannot show that any service reduced unmet need.
Declared interests
No author conflict-of-interest declaration is included in the supplied text. The publication types list NIH and U.S. government research support.
The easy way to misread this
Do not read the change from 28% to 24% as evidence that access improved or that a service worked. The study reports caregiver-identified unmet and unrecognized needs, not treatment effects.