Do Children Who Sustain Traumatic Brain Injury in Early Childhood Need and Receive Academic Services 7 Years After Injury?

Abstract

Objective Examine the prevalence of academic need, academic service utilization, and unmet need as well as factors associated with academic service utilization 6.8 years after traumatic brain injury (TBI) in early childhood. Method 58 (16 severe, 42 moderate) children with TBI and 72 children with orthopedic injury (OI) completed the long-term follow-up 6.8 years after injury in early childhood (ages 3–7 years). Injury group differences in rates of need for academic services, academic service utilization, and unmet need as well as factors associated with service utilization and unmet need were examined. Results Students with TBI (both moderate and severe) had significantly greater rates of need than those with OI. A greater proportion of the severe TBI sample were receiving academic services at long-term follow-up than other injury groups; however, among those with an identified need, injury group did not affect academic service utilization. Below average IQ/Achievement scores was the only area of need predictive of academic service utilization. Rate of unmet need was high across injury groups (46.2%–63.0%); with rates in the moderate TBI group greater than the OI group (although similar to the severe TBI group). Conclusion There is a high need for academic services among patients with a history of TBI during the preschool years 6.8 years post injury. Findings underscore the importance of continued monitoring of behaviors and academic performance in students with a history of early childhood TBI. This may be especially true among children with less severe injuries who are at risk for being underserved.

Effect of School Services on Academic Performance After Traumatic Brain Injury in Hispanic and Non‐Hispanic Students

“…It analyzes data collected 8 years ago, and the availability and accessibility of school services might have changed over time. However, in a recent study documenting receipt of school services among mostly NHW children with moderate and severe TBI, the proportion of participants who received school services was similar to ours . Furthermore, the finding of an association between receipt of services and academic performance should not vary over time.…”

Using Nonstandardized Assessments to Evaluate Cognitive-Communication Abilities following Pediatric Traumatic Brain Injury

“…50 Children who sustain injuries in early childhood (between 3 and 7 years) show high rates of unmet need nearly 7 years following TBI. 15 Unmet needs have been found to be highest for physiatry, educational, and speech-language services, and these needs were more common in individuals further from the point of injury and those with cmTBI. 13 While poor communication between hospitals and schools and knowledge barriers among parents and teachers explain some reasons why students with TBI are not receiving appropriate support services, 49,[51][52][53] even those children who have been properly identified and evaluated may end up having unmet needs in the school environment.…”

“…13 While poor communication between hospitals and schools and knowledge barriers among parents and teachers explain some reasons why students with TBI are not receiving appropriate support services, 49,[51][52][53] even those children who have been properly identified and evaluated may end up having unmet needs in the school environment. 13,15,54 In fact, longitudinal studies suggest that problems associated with TBI tend to persist or worsen as children progress through school. [54][55][56] Rates of unmet need are high and similar across severity levels (ranging from 46 to 64%), 15,53 though recent studies indicate that students with complicatedmild to moderate TBI show increasing needs longer-term.…”

“…13,15,54 In fact, longitudinal studies suggest that problems associated with TBI tend to persist or worsen as children progress through school. [54][55][56] Rates of unmet need are high and similar across severity levels (ranging from 46 to 64%), 15,53 though recent studies indicate that students with complicatedmild to moderate TBI show increasing needs longer-term. 54 Long-term sequelae may be more debilitating in children who are injured at a younger age, in part because many families lack an identified pathway to continued care or medical follow-up.…”

“…Early discharge is especially common among children with cmTBI (compared with moderate to severe TBI) and among older children (compared with younger children). 13,14 Related studies have revealed that outpatient health care services are similarly underutilized, 15,16 with unmet needs found to be highest among children whose injuries appeared to be less severe in the acute phase. 17,18 Not coincidentally, these students are also more likely to have an unmet need for speech-language pathology services in the months and years postinjury.…”