Children’s Safety Network eNewsletter: Featured TBI Journal Articles

Personal injury lawyer, Ian Mattoch, serves as president of Brain Injury Association of Hawaii. In order to advocate and keep informed about resources for his clients, Ian subscribes to TBISERV, the listserv for the Federal TBI Program. This week, TBISERV linked TBI journal articles featured in the Children’s Safety Network’s eNewsletter regarding Summer Dangers, Interactive Legislation Map, Bullying, and Suicide.


Online Problem-Solving Therapy for Executive Dysfunction after Child Traumatic Brain Injury, By: Brad G. Kurowski, MD, MSa, Shari L. Wade, PhDa, Michael W. Kirkwood, PhDb, Tanya M. Brown, PhDc, Terry Stancin, PhDd, and H. Gerry Taylor, PhDe

Official Journal of the American Academy of Pediatrics:
June 2013, 10.1542/peds.2012-4040
OBJECTIVE: Executive dysfunction after traumatic brain injury (TBI) in children is common and leads to significant problems in functioning across multiple settings. The objective of this study was to evaluate the efficacy of a web-based counselor-assisted problem solving (CAPS) intervention compared with an Internet resource comparison (IRC) for treatment of executive dysfunction within 12 months after complicated mild to severe TBI in adolescents. We hypothesized that CAPS would significantly improve parent ratings of executive dysfunction compared with an IRC.

METHODS: Participants included 132 adolescents aged 12 to 17 years who sustained a complicated mild to severe TBI within 1 to 6 months before study enrollment. Study design was a multisite, assessor-blinded, randomized controlled trial. Study sites included 3 tertiary pediatric hospitals and 2 tertiary general medical centers. The main outcome measure was primary caregiver Behavioral Rating Inventory of Executive Function Global Executive Composite at baseline and 6-month follow-up. Generalized linear models that controlled for baseline scores were used to compare the CAPS and IRC scores.

RESULTS: In older teens, the CAPS group showed significant improvement in executive function behaviors at 6-month follow-up compared with the IRC group (F = 6.74, P = .01, Cohen’s d = 0.63).

CONCLUSIONS: Findings indicate that web-based CAPS improves primary caregiver-rated executive functioning within the first 12 months after TBI in older adolescents. Future research needs to define the optimal timing after injury for delivery of CAPS and characteristics of individuals and families who are most likely to benefit from CAPS.

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Environmental Accommodations for a Child with Traumatic Brain Injury, By: Carrie Childers and Karen Hux

Brain Injury:
June 2013, Vol. 27, No. 7-8, Pages 850-861

PRIMARY OBJECTIVE: Children with severe TBI frequently demonstrate language and cognition challenges and require accommodations to succeed academically. However, minimal research exists about accommodation efficacy for this population. This study examined the effect of environmental accommodations (reduced visual and auditory

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distractions) on the redirections, task variability and accuracy of a child with severe TBI when performing cognitive-linguistic activities.

HYPOTHESIS: The researchers hypothesized no differences in variability between accommodation conditions; poorest task performance and most frequent task redirections given no environmental accommodations; comparable task performance and redirections with visual accommodation and auditory accommodation; and highest task performance and fewest redirections with combined visual and auditory accommodations.

RESEARCH DESIGN: The researchers used an alternating treatment, single case design to compare task performance, variability and redirection averages across conditions. They used visual inspection, linear growth curve analyses and repeated measure analyses for data interpretation.

METHODS AND PROCEDURES: Data collection occurred during label-object association, oral directions and divided attention tasks over 22 sessions varying in accommodation provision.

MAIN OUTCOMES AND RESULTS: Findings showed visual plus auditory accommodations resulted in fewer redirections and superior average performance on all tasks although substantial variability persisted. Significant differences emerged across conditions only for the oral directions task.

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