Article
Adaptive functioning following traumatic brain injury and orthopedic injury: A controlled study,☆☆

https://doi.org/10.1016/S0003-9993(98)90084-3Get rights and content

Abstract

Objective: To study adaptive functioning after severe traumatic brain injury (TBI).

Design: Case-control study.

Setting: A university hospital and three regional and four community hospitals.

Subjects: A consecutive series (n = 24) of children age 5 through 14 years who suffered severe TBI were individually matched to subjects who sustained a mild TBI and to a second group who sustained an orthopedic injury with no evidence of TBI.

Main Outcome Measures: Standardized adaptive functioning, intellectual, psychiatric, and neuroimaging assessments were conducted on average 2 years after injury.

Results: Severe TBI was associated with significantly (p < .05) lower Vineland Adaptive Behavior composite, communication, and socialization standard scores and lower Child Behavior Checklist parent-rated social competence scores compared with children with orthopedic injury. Severe TBI and mild TBI subjects were significantly (p < .05) more impaired than orthopedic subjects on teacher-rated adaptive function. Family functioning, psychiatric disorder in the child, and IQ were significant variables, explaining between 22% and 47% of the variance in adaptive functioning outcomes.

Conclusions: Severe TBI is associated with significant deficits in child adaptive functioning. This association appears to be mediated by family dysfunction, child psychiatric disorder, and intellectual deficits.

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    Supported by a National Alliance for Research in Schizophrenia and Affective Disorders Young Investigator Award to Dr. Max and National Institute of Mental Health grants MH31593, MH40856, and MHCRC43271 (Dr. Arndt).

    ☆☆

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

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