RECOVERY FROM TRAUMATIC BRAIN INJURY IN CHILDREN

遭受中重度创伤性脑损伤(TBI)的儿童 有长期神经行为后遗症的高风险。鲜为人知的是， 然而，关于儿童脑外伤对家庭的影响，或程度 颅脑损伤的康复受家庭环境的影响。这个 拟议的续建项目的目的是填补这一空白 通过延长对住院儿童样本的跟踪调查 6-12岁的儿童因脑外伤或骨科损伤而不是 涉及中枢神经系统的侮辱。最初的研究旨在遵循 儿童和家庭在受伤后的第一年。假设1是 这个年龄段的脑损伤对 家庭比骨科受伤更重要。假设2是 家庭环境的特征可以预测孩子的结果，甚至 伤后严重程度与儿童伤前行为功能 都被考虑在内了。初步发现支持这两种假说 并对脑外伤后青春期结局提出质疑 与骨科损伤相比。在拟议的项目中，大多数人 的当前研究参与者将返回进行三次延长的随访 每隔一年间隔。样本将包括41名儿童和 重度脑外伤青少年47例，中度脑损伤青少年54例 骨科损伤。尽管之前的措施将重新实施 假设不变，执行功能和执行功能的额外测试 将社会推理交给孩子们进行调查 这些领域后来出现的赤字。对家庭结果的评估 还将扩展到包括兄弟姐妹调整的措施，每天 家庭活动的电话日记，以及对 亲子互动。分析将集中在群体比较上， 随着时间的推移而变化，以及结果的预测因素。结果将会澄清 伤害后遗症，阐明风险和保护因素，并告知 努力减少颅脑损伤和其他创伤的长期发病率 童年时的伤痛。

Children who sustain moderate-to-severe traumatic brain injury (TBI) are at high risk for long-term neurobehavioral sequelae. Little is known, however, about the impact of pediatric TBI on families, or the extent to which recovery from TBI is influenced by the family environment. The purpose of the proposed continuation project is to fill this void through extended follow-up of a sample of children who were hospitalizes between the ages of 6-12 years for either TBI or orthopedic injuries not involving CNS insult. The original study was designed to follow children and families over the first post-injury year. Hypothesis 1 was that TBI in this age group has more adverse and enduring effects on families than orthopedic injuries. Hypothesis 2 was that characteristics of the family environment predict child outcomes, even after injury severity and the child's pre-injury behavioral functioning are taken into account. Preliminary findings support both hypotheses and raise questions with regard to the later, adolescent outcomes of TBI compared to orthopedic injuries. In the proposed project, the majority of current study participants will return for three extended follow-up spaced at one-year intervals. The sample will include 41 children and adolescents with severe TBI, 47 with moderate TBI, and 54 with orthopedic injuries. although previous measures will be readministered and hypotheses are unchanged, additional tests of executive function and social reasoning will be given to the children to investigate later-emerging deficits in these areas. Assessments of family outcomes will also be expanded to include measures of sibling adjustment, daily phone diaries of family activities, and direct observations of parent-child interactions. Analysis will focus on group comparisons, changes over time, and predictors of outcome. Results will clarify injury sequelae, shed light on risk and protective factors, and inform efforts to reduce the long-term morbidity of TBI and other traumatic childhood injures.