Trajectories of Executive Functions After Early Childhood Traumatic Brain Injury: Teacher Ratings in the Initial 81 Months Postinjury.
Gary Rempe, Christine Petranovich, Megan E Narad and 4 others
PMID 36730995WHAT IT FOUND
Teacher ratings showed two groups: 65% stayed in the normal range, while 35% had executive function concerns that worsened over time.
Children in the struggling group were more likely to have had a brain injury, lower socio-economic status, and authoritarian parenting.
Key findings
01Children with traumatic brain injury were more likely than those with orthopedic injury to fall into the group with worsening executive function problems.
02Authoritarian parenting was associated with increasing executive function problems over time in the group at risk for difficulties.
03Children in the at-risk trajectory had lower socio-economic status and were more likely to receive academic support services.
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
The sample size was relatively small (121 children), which may have limited the ability to detect more subtle trajectory differences. Teachers changed over the course of the study, meaning different raters assessed the child at different time points. Both preschool and school-age versions of the BRIEF were used, which have different content, potentially contributing to the observed increase in scores. Data on academic services (IEPs) were only collected at the final time point, not over time. Participants included in the analysis had slightly higher socio-economic status than those who dropped out, which may bias results.
Declared interests
The study was supported by the National Institute of Health (N.I.H.) and non-U.S. government research support. No specific conflicts of interest regarding commercial entities were detailed in the provided text.
The easy way to misread this
Do not assume that a child with early childhood TBI will maintain a typical executive function profile if they started in the normal range. The study found that executive function concerns increased over time in both groups, and those in the At-Risk group crossed into significantly elevated levels by 81 months. Furthermore, 31% of children with severe TBI remained in the Normative group, so injury severity alone does not predict the trajectory.