TY - JOUR
T1 - Adaptive functioning following traumatic brain injury and orthopedic injury
T2 - A controlled study
AU - Max, Jeffrey E.
AU - Koele, Sharon L.
AU - Lindgren, Scott D.
AU - Robin, Donald A.
AU - Smith, Wilbur L.
AU - Sato, Yutaka
AU - Arndt, Stephan
N1 - Funding Information:
From the Department of Psychiatry (Drs. Max, Koele, Amdt), the Department of Radiology (Drs. Smith, Sate), the Department of Pediatrics (Dr. Lindgren), and the Department of Speech Pathology and Audiology (Dr. Robin), University of Iowa, Iowa City. Submitted for publication September 4, 1997. Accepted in revised form February 17, 1998. 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. Amdt). 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. Reprint requests to Jeffrey E. Max, MBBCh, Department of Psychiatry, The University of Iowa, 1876 JPP, Iowa City, IA 52242. 0 1998 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation 0003-9993/98/7908-4643$3.00/O
PY - 1998/8
Y1 - 1998/8
N2 - 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.
AB - 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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U2 - 10.1016/S0003-9993(98)90084-3
DO - 10.1016/S0003-9993(98)90084-3
M3 - Article
C2 - 9710159
AN - SCOPUS:0031821891
VL - 79
SP - 893
EP - 899
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
SN - 0003-9993
IS - 8
ER -