Research Reports - The family environment predicts long-term academic achievement and classroom behavior following traumatic brain injury in early childhood

Neuropsychology. 2017 Jul;31(5):499-507. doi: 10.1037/neu0000351. Epub 2017 May

Durber CM(1), Yeates KO(2), Taylor HG(3), Walz NC(4), Stancin T(5), Wade SL(6).

OBJECTIVE: This study examined how the family environment predicts long-term
academic and behavioral functioning in school following traumatic brain injury
(TBI) in early childhood.
METHOD: Using a concurrent cohort, prospective design, 15 children with severe
TBI, 39 with moderate TBI, and 70 with orthopedic injury (OI) who were injured
when they were 3-7 years of age were compared on tests of academic achievement
and parent and teacher ratings of school performance and behavior on average 6.83
years postinjury. Soon after injury and at the longer term follow-up, families
completed measures of parental psychological distress, family functioning, and
quality of the home environment. Hierarchical linear regression analyses examined
group differences in academic outcomes and their associations with measures of
the early and later family environment.
RESULTS: The severe TBI group, but not the moderate TBI group, performed worse
than did the OI group on all achievement tests, parent ratings of academic
performance, and teacher ratings of internalizing problems. Higher quality early
and late home environments predicted stronger academic skills and better
classroom behavior for children with both TBI and OI. The early family
environment more consistently predicted academic achievement, whereas the later
family environment more consistently predicted classroom functioning. The quality
of the home environment predicted academic outcomes more strongly than did
parental psychological distress or family functioning.
CONCLUSION: TBI in early childhood has long-term consequences for academic
achievement and school performance and behavior. Higher quality early and later
home environments predict better school outcomes for both children with TBI and
children with OI.  

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