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Wright B, Venkatesan UM, Pinto SM, Gary KW, O'Neil-Pirozzi TM, Kajankova M, Wilmoth K, Kakkanatt A, Dreer L, Juengst SB. Predictors of High School and College Graduation After Sustaining a Moderate-to-Severe Traumatic Brain Injury. J Head Trauma Rehabil 2023; 38:249-258. [PMID: 35862899 DOI: 10.1097/htr.0000000000000806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify early predictors of US high school and college graduation after moderate-to-severe traumatic brain injury (TBI). SETTING Inpatient rehabilitation and community. PARTICIPANTS TBI Model Systems participants, aged 16 to 24 years, enrolled as high school or college students at time of injury. DESIGN Prospective cohort study. MAIN MEASURES Successful graduation was defined as having a diploma (high school) or an associate/bachelor's degree (college) at 1-, 2-, or 5-year follow-up. Predictors were sex, race/ethnicity, urbanicity, preinjury substance abuse, primary rehabilitation payer, and functional independence at inpatient rehabilitation discharge. METHOD We descriptively characterized differences between those who did and did not graduate high school and college within the first 5 years postinjury and identified early predictors of successful high school and college graduation using 2 binomial logistic regressions. RESULTS Of those with known graduation status, 81.2% of high school and 41.8% of college students successfully graduated. Graduates in both groups were more often White than Black and had more functional independence at discharge. Among high school students, preinjury substance abuse was also a risk factor for not graduating, as was identifying as Hispanic or "other" race. CONCLUSIONS Sociodemographic factors and disability influence graduation outcomes, requiring structural, institutional, and personal interventions for success.
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Affiliation(s)
- Brittany Wright
- Departments of Physical Medicine & Rehabilitation (Drs Wright, Pinto, Wilmoth, and Juengst) and Psychiatry (Dr Wilmoth), University of Texas Southwestern Medical Center, Dallas; Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania (Dr Venkatesan); Department of Physical Medicine and Rehabilitation, Carolinas Rehabilitation, Charlotte, North Carolina (Dr Pinto); Department of Rehabilitation Counseling, Virginia Commonwealth University, Richmond (Dr Gary); Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation, Hospital, Boston, Massachusetts (Dr O'Neil-Pirozzi); Department of Communication Sciences and Disorders, Northeastern University, Boston, Massachusetts (Dr O'Neil-Pirozzi); Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York (Dr Kajankova); Department of Physical Medicine and Rehabilitation, Hackensack Meridian Health, Edison, New Jersey (Dr Kakkanatt); Departments of Ophthalmology & Visual Sciences and Physical Medicine & Rehabilitation, University of Alabama at Birmingham (Dr Dreer); and TIRR Memorial Hermann, Brain Injury Research Center, Houston, Texas (Dr Juengst)
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Crumlish L, Wallace SJ, Copley A, Rose TA. Exploring the measurement of pediatric cognitive-communication disorders in traumatic brain injury research: A scoping review. Brain Inj 2022; 36:1207-1227. [PMID: 36303459 DOI: 10.1080/02699052.2022.2111026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To synthesize information about the constructs measured, measurement instruments used, and the timing of assessment of cognitive-communication disorders (CCDs) in pediatric traumatic brain injury (TBI) research. METHODS AND PROCEDURES Scoping review conducted in alignment with Arksey and O'Malley's five-stage methodological framework and reported per the PRISMA extension for Scoping Reviews. Inclusion criteria: (a) cohort description, case-control, and treatment studies; (b) participants with TBI aged 5-18 years; (c) communication or psychosocial outcomes; and (d) English full-text journal articles. The first author reviewed all titles, abstracts, and full-text articles; 10% were independently reviewed. OUTCOMES AND RESULTS Following screening, a total of 687 articles were included and 919 measurement instruments, measuring 2134 unique constructs, were extracted. The Child Behavior Checklist was the most used measurement instrument and 'Global Outcomes/Recovery' was the construct most frequently measured. The length of longitudinal monitoring ranged between ≤3 months and 16 years. CONCLUSIONS AND IMPLICATIONS We found considerable heterogeneity in the constructs measured, the measurement instruments used, and the timing of CCD assessment in pediatric TBI research. A consistent approach to measurement may support clinical decision-making and the efficient use of data beyond individual studies in systematic reviews and meta-analyses.
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Affiliation(s)
- Lauren Crumlish
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sarah J Wallace
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Queensland Aphasia Research Centre, Australia
| | - Anna Copley
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Tanya A Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Queensland Aphasia Research Centre, Australia
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Ahonle ZJ, Tucker M, Degeneffe CE, Romero S, Dillahunt-Aspillaga C. Return to School Outcomes among Adults with TBI One Year After Rehabilitation Discharge: A TBIMS Study. Brain Inj 2022; 36:1000-1009. [PMID: 35916683 DOI: 10.1080/02699052.2022.2105952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To examine return to school outcomes 1 year after traumatic brain injury (TBI) rehabilitation discharge. DESIGN Longitudinal observational study using Traumatic Brain Injury Model Systems National Database (TBIMS-NDB) data at 1-year post-TBI. SETTING Inpatient rehabilitation centers using follow-up telephone calls. INDIVIDUALS Individuals (n = 237) enrolled in the TBIMS-NDB since 2001 between the ages of 18 and 59 years who were engaged in postsecondary education (full or part-time) before recorded TBI. MAIN MEASURES Return to school, categorized as in a postsecondary setting at first follow-up (reported hours in school greater than zero at one-year follow-up). RESULTS Using an alpha level of 0.05 binary logistic regression analysis identified four predictive variables. Significant predictors of return to school include being of lower age, possessing a higher level of functioning at discharge, reporting lower ratings of disability at discharge, and being able to use a vehicle independently for transportation. CONCLUSION Pursuit of higher education is a viable means of community reintegration after TBI. Some individuals with TBI face a myriad of barriers and challenges when returning to school. Study findings may facilitate understanding of how TBI affects return to school and community reintegration outcomes.
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Affiliation(s)
- Zaccheus James Ahonle
- Department of Occupational Therapy, College of Public Health & Health Professions, University of Florida, Florida, US.,Veteran Rural Health Resource Center, Gainesville (VRHRC-GNV), Florida, US.,Rehabilitation Counseling Program, Department of Counseling, Educational Psychology & Foundations, Mississippi State University, Starkville, MS, US
| | - Mark Tucker
- Rehabilitation Counseling Program, Department of Administration, Rehabilitation, and Postsecondary Education, San Diego State University, San Diego, California, US
| | - Charles Edmund Degeneffe
- Rehabilitation Counseling Program, Department of Administration, Rehabilitation, and Postsecondary Education, San Diego State University, San Diego, California, US
| | - Sergio Romero
- Department of Occupational Therapy, College of Public Health & Health Professions, University of Florida, Florida, US.,Veteran Rural Health Resource Center, Gainesville (VRHRC-GNV), Florida, US
| | - Christina Dillahunt-Aspillaga
- Rehabilitation & Mental Health Counseling Program, Child & Family Studies, University of South Florida, Tampa, Florida, US
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Tarnai K, Marcopulos B. Developing a model of return to school: A Traumatic Brain Injury Model Systems study. Brain Inj 2022; 36:544-552. [PMID: 35380490 DOI: 10.1080/02699052.2022.2051739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE A common goal for those recovering from moderate to severe brain injury is to reengage in education or employment. There is significant overlap between the skills relevant for successful job and academic performance in high school and college, and many deficits reported after brain injury are consistent across young adults and adults. This study utilized a return to work (RTW) model framework to develop a model of return to school (RTS). METHOD Days of post-traumatic amnesia (PTA), length of stay (LOS), rehabilitation discharge Disability Rating Scale (DRS) scores, presence of pre-injury learning limitation, and educational level were used to predict RTS one-year post-injury in a student sample (N = 158, 58.8% white, 69.6% male) within the Traumatic Brain Injury Model Systems National Database. RESULTS The overall RTS rate for this sample was 62%. Logistic regression indicated that lower DRS discharge scores and being in high school pre-injury resulted in the best outcome. CONCLUSION Results showed partial support for the translation of RTW factors to a student sample; however, results may also favor the conceptual distinction in RTS versus RTW, which are elaborated. More outreach for college students may improve awareness of disability services, thereby heightening the future return rate.
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Affiliation(s)
- Kathryn Tarnai
- Department of Graduate Psychology, James Madison University, Harrisonburg, Virginia, USA
| | - Bernice Marcopulos
- Department of Graduate Psychology, James Madison University, Harrisonburg, Virginia, USA.,Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia, USA
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Wales L, Davis K, Kelly G, Lynott H. Long Term Participation Outcomes for Severe Acquired Brain Injury in Childhood - An Expanded Scoping Review. Dev Neurorehabil 2021; 24:379-387. [PMID: 33615981 DOI: 10.1080/17518423.2021.1886191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction: Participation in childhood Acquired Brain Injury (ABI) lacks clarity in definition and determinants influencing long-term outcome. This paper aims to investigate and identify the factors that impact long-term outcomes, and prioritize the measures that focus on and endorse children, young people, and their family's concept of participation.Methods: A scoping review was carried out using research literature and non-research data sources including data review, child/family interviews, and expert consultation.Results: Six peer-reviewed papers sourced. Families reported that participation for the whole family is important and recovers in a non-linear manner after rehabilitation. Experts agreed the priority and complexity of participation following severe ABI.Conclusion: Review highlights that regaining participation through the attendance at, and the engagement in life situations, for children after severe ABI, is important, complex and is affected by many factors.Future research requires a flexible approach to understand participation and inform future targeted interventions.
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Affiliation(s)
- Lorna Wales
- Research Professional Lead, The Children's Trust, Tadworth, UK
| | - Kathy Davis
- Research Nurse, The Children's Trust, Tadworth, UK
| | - Gemma Kelly
- Research Physiotherapist, the Children's Trust, Tadworth, UK
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Pei Y, O'Brien KH. Reading Abilities Post Traumatic Brain Injury in Adolescents and Adults: A Systematic Review and Meta-Analysis. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:789-816. [PMID: 33755512 DOI: 10.1044/2020_ajslp-20-00213] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose People with traumatic brain injury (TBI) often struggle with complex reading, limiting participation in work and educational settings. This systematic review and meta-analysis examined studies of reading conducted with adolescents and adults with TBI to describe reading problems post TBI and investigate underlying factors for the effects of TBI on reading abilities. Method The search was conducted in EBSCO (including MEDLINE, PsycINFO, etc.), BIOSIS, ProQuest, and Web of Science. Empirical studies that used samples with a mean age greater than 10 years, reported injury characteristics, and investigated complex reading abilities (defined as greater than single-word reading) were eligible for this review. Study quality was evaluated using QualSyst. Study and sample characteristics, measures, and outcomes of interest were extracted and synthesized in the review. Studies that compared reading abilities between people with and without TBI were included in the meta-analysis. Results Twenty-four studies met inclusion criteria, six of which addressed reading in pediatric samples. Findings from heterogeneous samples supported the existence of reading deficits post TBI, including mild TBI. In studies of children, comprehension was examined most frequently, whereas reading speed was the focus of most adult studies. Oculomotor functions and processing speed were related to reading speed; cognitive functions, such as attention and memory, were associated with reading comprehension. Intervention studies were limited, but most reported positive effects. The meta-analysis confirmed the impact of TBI on reading with a large effect size (g = 1.23). Demographic, injury, and study variables did not moderate overall reading outcomes, but male sex was a significant moderator of impairment in reading speed. Discussion Global reading ability, including both comprehension and speed, is negatively impacted by TBI. Future research should continue to explore reading after TBI, including its underlying mechanisms, effects on complex reading activities such as inferencing, development of screening and assessment tools that address a range of functional reading needs, and efficacy of reading-related interventions.
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Affiliation(s)
- Yalian Pei
- Department of Communication Sciences and Special Education, University of Georgia, Athens
| | - Katy H O'Brien
- Department of Communication Sciences and Special Education, University of Georgia, Athens
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Ryttersgaard TO, Riis JØ, Johnsen SP, Mogensen PH, Bjarkam CR. Depression and cognitive sequelae registered within the first year among young Danish TBI survivors. Scand J Psychol 2020; 61:663-670. [PMID: 32596856 DOI: 10.1111/sjop.12660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 05/11/2020] [Indexed: 12/01/2022]
Abstract
The aim of the study was to determine the proportion of depression and cognitive sequelae among young (15-30 years) Danish TBI survivors referred to interdisciplinary evaluation through a nationwide government-initiated health initiative. The cross-sectional study is based on data from the "Danish register for young adults with acquired brain injury" on TBI survivors included from October 2013 to December 2016. The main measures were Major depression inventory, Trail making test A and B, Fluency, Word learning with selective reminding, Matrix reasoning, Coding and Glasgow outcome scale - extended (GOS-E). During the study period, 131 young TBI survivors were referred to one of five national outpatient clinics. Ninety-six had complete data and of these 14.6% fulfilled the ICD-10 diagnostic criteria for depression and 34.4% had cognitive sequelae. An association was found between depression and cognitive sequelae (p = 0.004). Patients with both depression and cognitive sequelae (n = 10) had a significantly lower mean score on GOS-E (p = 0.0001). Depression and cognitive sequelae were frequent and associated with a poorer global functional outcome among young TBI survivors referred within a year after trauma. This finding and the notion that only 20% of the expected TBI population was referred to this nationwide health initiative indicate an unacknowledged need for interdisciplinary follow-up.
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Affiliation(s)
- Trine Okkerstrøm Ryttersgaard
- Department of Neurology, Institute of Clinical Medicine, Aalborg University Hospital, Ladegårdsgade 5, 7th, Aalborg, 9000, Denmark
| | - Jens Østergaard Riis
- Department of Neurosurgery, Aalborg University Hospital, Hobrovej 18, Aalborg, 9000, Denmark
| | - Søren Paaske Johnsen
- Danish Center for Clinical Health Services Research, Institute of Clinical Medicine, Aalborg University and Aalborg University Hospital, Mølleparkvej 10, Aalborg, 9000, Denmark
| | - Poul Henning Mogensen
- Department of Neurology, Aalborg University Hospital, Ladegårdsgade 5, 7th, Aalborg, 9000, Denmark
| | - Carsten Reidies Bjarkam
- Department of Neurosurgery, Institute of Clinical Medicine, Aalborg University Hospital, Hobrovej 18, Aalborg, 9000, Denmark
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Return to Productivity Projections for Individuals With Moderate to Severe TBI Following Inpatient Rehabilitation: A NIDILRR TBIMS and CDC Interagency Collaboration. J Head Trauma Rehabil 2020; 35:140-151. [DOI: 10.1097/htr.0000000000000506] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ryttersgaard TO, Johnsen SP, Riis JØ, Mogensen PH, Bjarkam CR. Prevalence of depression after moderate to severe traumatic brain injury among adolescents and young adults: A systematic review. Scand J Psychol 2019; 61:297-306. [DOI: 10.1111/sjop.12587] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 09/05/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Trine O. Ryttersgaard
- Department of Neurology Institute of Clinical Medicine Aalborg University Hospital Aalborg Denmark
| | - Søren P. Johnsen
- Danish Center for Clinical Health Services Research Institute of Clinical Medicine Aalborg University and Aalborg University Hospital Aalborg Denmark
| | - Jens Ø. Riis
- Department of Neurosurgery Aalborg University Hospital Aalborg Denmark
| | - Poul H. Mogensen
- Department of Neurology Aalborg University Hospital Aalborg Denmark
| | - Carsten R. Bjarkam
- Department of Neurosurgery Institute of Clinical Medicine Aalborg University Hospital Aalborg Denmark
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Ruet A, Jourdan C, Bayen E, Darnoux E, Sahridj D, Ghout I, Azerad S, Pradat Diehl P, Aegerter P, Charanton J, Vallat Azouvi C, Azouvi P. Employment outcome four years after a severe traumatic brain injury: results of the Paris severe traumatic brain injury study. Disabil Rehabil 2017; 40:2200-2207. [PMID: 28521527 DOI: 10.1080/09638288.2017.1327992] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To describe employment outcome four years after a severe traumatic brain injury by the assessment of individual patients' preinjury sociodemographic data, injury-related and postinjury factors. DESIGN A prospective, multicenter inception cohort of 133 adult patients in the Paris area (France) who had received a severe traumatic brain injury were followed up postinjury at one and four years. Sociodemographic data, factors related to injury severity and one-year functional and cognitive outcomes were prospectively collected. METHODS The main outcome measure was employment status. Potential predictors of employment status were assessed by univariate and multivariate analysis. RESULTS At the four-year follow-up, 38% of patients were in paid employment. The following factors were independent predictors of unemployment: being unemployed or studying before traumatic brain injury, traumatic brain injury severity (i.e., a lower Glasgow Coma Scale score upon admission and a longer stay in intensive care) and a lower one-year Glasgow Outcome Scale-Extended score. CONCLUSION This study confirmed the low rate of long-term employment amongst patients after a severe traumatic brain injury. The results illustrated the multiple determinants of employment outcome and suggested that students who had received a traumatic brain injury were particularly likely to be unemployed, thus we propose that they may require specific support to help them find work. Implications for rehabilitation Traumatic brain injury is a leading cause of persistent disablity and can associate cognitive, emotional, physical and sensory impairments, which often result in quality-of-life reduction and job loss. Predictors of post-traumatic brain injury unemployment and job loss remains unclear in the particular population of severe traumatic brain injury patients. The present study highlights the post-traumatic brain injury student population require a close follow-up and vocational rehabilitation. The study suggests that return to work post-severe traumatic brain injury is frequently unstable and workers often experience difficulties that caregivers have to consider.
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Affiliation(s)
- Alexis Ruet
- a Service de Médecine Physique et de Réadaptation , CHU de Caen , France.,b U1077, INSERM , Caen , France
| | - Claire Jourdan
- c Service de Médecine Physique et de Réadaptation , APHP, Hôpital Raymond Poincaré , Garches , France.,d EA 4047 HANDIReSP , Université de Versailles Saint-Quentin , France
| | - Eléonore Bayen
- e Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière , Service de Médecine Physique et Réadaptation, Paris, France, Université Pierre et Marie Curie , Paris , France
| | - Emmanuelle Darnoux
- f Assistance Publique-Hôpitaux de Paris , Hôpital Ambroise Paré, Unité de Recherche Clinique (URC) , Boulogne , France.,g Centre Ressources Francilien du Traumatisme Crânien (CRFTC) , Paris , France
| | - Dalila Sahridj
- c Service de Médecine Physique et de Réadaptation , APHP, Hôpital Raymond Poincaré , Garches , France
| | - Idir Ghout
- f Assistance Publique-Hôpitaux de Paris , Hôpital Ambroise Paré, Unité de Recherche Clinique (URC) , Boulogne , France
| | - Sylvie Azerad
- f Assistance Publique-Hôpitaux de Paris , Hôpital Ambroise Paré, Unité de Recherche Clinique (URC) , Boulogne , France
| | - Pascale Pradat Diehl
- e Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière , Service de Médecine Physique et Réadaptation, Paris, France, Université Pierre et Marie Curie , Paris , France
| | - Philippe Aegerter
- f Assistance Publique-Hôpitaux de Paris , Hôpital Ambroise Paré, Unité de Recherche Clinique (URC) , Boulogne , France
| | - James Charanton
- g Centre Ressources Francilien du Traumatisme Crânien (CRFTC) , Paris , France
| | - Claire Vallat Azouvi
- d EA 4047 HANDIReSP , Université de Versailles Saint-Quentin , France.,h Antenne UEROS-SAMSAH 92-UGECAM IDF , Hôpital Raymond Poincaré , Garches , France
| | - Philippe Azouvi
- c Service de Médecine Physique et de Réadaptation , APHP, Hôpital Raymond Poincaré , Garches , France.,d EA 4047 HANDIReSP , Université de Versailles Saint-Quentin , France
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Steel J, Ferguson A, Spencer E, Togher L. Speech-language pathologists’ perspectives on cognitive communication assessment during post-traumatic amnesia. Brain Inj 2016; 30:1131-42. [DOI: 10.1080/02699052.2016.1174785] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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