Research Reports - Predictors of cognitive functioning following pediatric traumatic brain injury

J Int Neuropsychol Soc. 2016 May;22(5):512-9. doi: 10.1017/S1355617716000175.
Epub 2016 Mar 28.

Moran LM(1), Babikian T(1), Del Piero L(2), Ellis MU(1), Kernan CL(1), Newman
N(1), Giza CC(3), Mink R(4), Johnson J(5), Babbitt C(6), Asarnow R(1).

OBJECTIVES: Following pediatric moderate-to-severe traumatic brain injury
(msTBI), few predictors have been identified that can reliably identify which
individuals are at risk for long-term cognitive difficulties. This study sought
to determine the relative contribution of detailed descriptors of injury severity
as well as demographic and psychosocial factors to long-term cognitive outcomes
after pediatric msTBI.
METHODS: Participants included 8- to 19-year-olds, 46 with msTBI and 53 uninjured
healthy controls (HC). Assessments were conducted in the post-acute and chronic
stages of recovery. Medical record review provided details regarding acute injury
severity. Parents also completed a measure of premorbid functioning and
behavioral problems. The outcome of interest was four neurocognitive measures
sensitive to msTBI combined to create an index of cognitive performance.
RESULTS: Results indicated that none of the detailed descriptors of acute injury
severity predicted cognitive performance. Only the occurrence of injury, parental
education, and premorbid academic competence predicted post-acute cognitive
functioning. Long-term cognitive outcomes were best predicted by post-acute
cognitive functioning.
DISCUSSION: The findings suggest that premorbid factors influence cognitive
outcomes nearly as much as the occurrence of a msTBI. Furthermore, of youth with
msTBI who initially recover to a level of moderate disability or better, a brief
cognitive battery administered within several months after injury can best
predict which individuals will experience poor long-term cognitive outcomes and
require additional services. 

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