The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #70688

Penny Glass, PhD¹, Stephanie Townsend, BA¹, Jessica Thornton, BA¹, Sherry Billings, MEd², and John O Davies Cole, PhD, MPH². (1) Child Development Program, Children's National Medical Center, 111 Michigan Avenue, NW, Suite 3800, Washington, DC 20010, (202) 884-2132, pglass@cnmc.org, (2) Bureau of Epidemiology and Health Risk Assessment, District of Columbia Department of Health, 825 North Capitol St., NE, 3rd Fl., Rm. 3142, Washington, DC 20002

Objectives: Traumatic brain injury (TBI) is a major public health problem affecting 1:500 children annually.¹ Previously, we reported neurodevelopmental outcomes in children 1-3 years old who had sustained TBI prior to age 1 year.² We continue our follow-up of this cohort in order to characterize developmental status after the 3rd birthday and determine access to appropriate educational and therapeutic resources. Methods: Structured telephone interviews of primary caregivers were conducted. Outcome data is currently available for 20 children. Brain injury severity was classified from neuroradiology report of computed tomography (CT) scans in the acute injury period. Results: TBI Severity Distribution: Severe = 5, Moderate = 3, Mild = 9. Two scans showed no hemorrhage. One scan has not yet been scored. Neurological Status: 50% have ongoing neurological issues, including cerebral palsy (25%) and epilepsy (15%). Adaptive Function: Mean Adaptive Composite Score is 83, but 35% have composite scores in the significantly delayed range (>2 sd below the mean). Behavior Ratings: 50% have clinically significant behavioral rating scores (>2 sd below the mean). School Performance: 70% have needed special treatment or therapy to help with development or behavior; 45% have attended special classes, daycare, or school for children with special needs. Of the 14 children attending grades K-3, 50% have school problems. Conclusions: This sample has been well connected to the medical and educational communities. Behavioral issues do not appear to have received adequate therapeutic support. Whether more subtle learning disabilities are present among children with no reported academic problems remains unclear.

Learning Objectives:

Participation in the session will enable learners to:
• Recognize traumatic brain injury in infants as a major health problem,
• Describe the expected outcomes after age three years following moderate-severe traumatic brain injury in infancy, and
• Recognize the need for therapeutic intervention in children who sustained only mild TBI prior to age one year.

Keywords: Traumatic Brain Injury, Outcomes Research

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.