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The UCLA study of Predictors of Cognitive Functioning Following Moderate/Severe Pediatric Traumatic Brain Injury

Published online by Cambridge University Press:  28 March 2016

Lisa M. Moran
Affiliation:
Department of Psychiatry and Biobehavioral Health, University of California, Los Angeles, California
Talin Babikian*
Affiliation:
Department of Psychiatry and Biobehavioral Health, University of California, Los Angeles, California Department of Pediatrics, University of California, Los Angeles, California
Larissa Del Piero
Affiliation:
Department of Psychology, University of Southern California, Los Angeles, California
Monica U. Ellis
Affiliation:
Department of Psychiatry and Biobehavioral Health, University of California, Los Angeles, California Department of Psychology, Fuller Theological Seminary, Pasadena, California
Claudia L. Kernan
Affiliation:
Department of Psychiatry and Biobehavioral Health, University of California, Los Angeles, California
Nina Newman
Affiliation:
Department of Psychiatry and Biobehavioral Health, University of California, Los Angeles, California
Christopher C. Giza
Affiliation:
Department of Pediatrics, University of California, Los Angeles, California Brain Injury Research Center, University of California, Los Angeles, California Department of Neurosurgery and Division of Pediatric Neurology, Mattel Children’s Hospital, Los Angeles, California
Richard Mink
Affiliation:
Department of Pediatrics, Los Angeles County & Harbor University of California, Los Angeles, California
Jeffrey Johnson
Affiliation:
Department of Pediatrics, Los Angeles County & University of Southern California Medical Center, Los Angeles, California
Christopher Babbitt
Affiliation:
Department of Pediatrics, Miller Children’s Hospital, Long Beach, California
Robert Asarnow
Affiliation:
Department of Psychiatry and Biobehavioral Health, University of California, Los Angeles, California Department of Psychology, University of California, Los Angeles, California Brain Research Institute, University of California, Los Angeles, California
*
Correspondence and reprint requests to: Talin Babikian, Division of Child and Adolescent Psychiatry, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095. E-mail: tbabikian@mednet.ucla.edu

Abstract

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. (JINS, 2016, 22, 1–8)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2016 

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