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Journal of Pediatric Psychology Advance Access published online on October 9, 2009
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsp081
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© The Author 2009. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Parent Ratings of Behavioral Functioning After Traumatic Brain Injury in Very Young Children

Crista E Wetherington, PhD1,2, Stephen R Hooper, PhD3,4,5, Heather T Keenan, MDCM PhD6, Maryalice Nocera, MSN7 and Desmond Runyan, MD DrPH4,7,8

1Center for Pediatric Psychiatry, Children's Medical Center Dallas, 2Department of Psychiatry, University of Texas Southwestern Medical Center, 3Department of Psychiatry, 4Department of Pediatrics, 5The Clinical Center for the Study of Development and Learning, Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, 6Department of Pediatrics, University of Utah School of Medicine, 7Injury Prevention Research Center, and 8Departments of Social Medicine & Pediatrics, University of North Carolina School of Medicine

All correspondence concerning this article should be addressed to Stephen R. Hooper, The Clinical Center for the Study of Development and Learning, CB# 7255, University of North Carolina School of Medicine, Chapel Hill, NC, 27599-7255, USA. E-mail: stephen.hooper{at}cdl.unc.edu


  Abstract

Objective The behavioral ratings of preschoolers who sustained traumatic brain injury (TBI) prior to the age of 2 years and a typically developing group were compared; predictors of behavioral functioning were examined. Methods Eighty-two 3-year-olds comprised mild TBI (n = 31), moderate/severe TBI (n = 20), and typically developing (n = 31) groups, with Child Behavior Checklist (CBCL) as the primary outcome measure. Results Groups differed on the CBCL Withdrawal Scale. No differences emerged in the proportion of children demonstrating clinical elevations, with average mean scores for each group. Exploratory analyses yielded no differences between inflicted, non-inflicted, and typical groups. Glasgow Coma Scale and Self-Report Family Inventory Leadership predicted Externalizing Problems; developmental level predicted Internalizing Problems. Conclusions After early TBI, preschoolers did not differ from one another or a matched comparison group in behavioral ratings; however, it may be premature to infer that preschoolers do not evidence behavioral dysfunction after early TBI.

Key words: Behavioral ratings post traumatic brain injury; preschool traumatic brain injury; traumatic brain injury..

Received November 24, 2008; revision received August 16, 2009; accepted August 17, 2009


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