GRANT #312 Ten-year Outcomes following Traumatic Brain Injury (TBI) in Childhood

Dr Kelly Jones.
Senior Lecturer Registered psychologist specialising in paediatrics.


Every year in New Zealand (NZ), approximately 18,000 children (aged 0-15 years) sustain a traumatic brain injury (TBI)[1], placing them at risk for a vast range of adverse effects. Compared to adults, these injuries may be especially detrimental to children given their on-going and often rapid development and associated physiological and neurological vulnerabilities. Yet, the full extent of the long-term impact of TBI on children’s development, especially mild brain injuries, and how multiple brain injuries affect recovery and children’s development remain unknown. Without advanced knowledge of the true long-term consequences of TBI for children, it is near impossible to develop and deliver appropriately targeted treatments to promote recovery and the continuation of children’s development along a normative pathway. This study extends the previous 6-year follow-up study of children with mild TBI which examined acute to medium-term outcomes (funded by the Health Research Council of New Zealand and Waikato Medical Research Foundation) to a 10-year follow-up study examining long-term outcomes. Parents and children who have previously been identified and assessed at semi-regular intervals over 6-years post-injury, and who have agreed to further contact will be invited to complete a one-off, single assessment of their child’s development, functioning, and well-being at 10-years post-

TBI. The assessment will include parent and/or child self-report questions about each child’s thinking and problem-solving skills, behaviour, and quality of life (QoL). Children will also complete a computerised assessment of their cognitive function. By drawing on existing data collected at earlier time points, children’s functioning in these areas will be examined over time to highlight any areas of change and/or on-going difficulties. Children’s functioning will also be compared to children of the same age and sex who are TBI-free in order to identify any significant delays and/or divergences in development. These comparisons will enable the identification of predictors of good and poor outcomes at 10-years and specific patterns of development post-TBI. We will also identify those children with mild TBI who have experienced any additional brain injuries since their last follow-up assessment to explore the impact of multiple injuries. Study findings will help researchers, rehabilitation providers, and health and education professionals to better understand a) the impact of mild TBI on children’s outcomes over time and compared to same-aged peers free from TBI; b) how child factors, injury characteristics and post-injury surroundings are related to long-term recovery at 10-years post-injury; and c) whether those at risk of on-going problems can be identified early to enable the provision of targeted, age-appropriate and effective intervention services. Building on our most recent follow-up of this cohort at 6-years post-injury, this information is vital for evidence-based long-term health care planning for children post-TBI. Findings will also help to ensure that those children with increased risk for additional brain injuries and/or poor development and well-being after injury and their families/whānau receive the type of targeted support that will be beneficial for preventing injury and maximising long-term recovery.

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