Results from a randomized trial evaluating a hospital–school transition support model for students hospitalized with traumatic brain injury

ABSTRACT

Objective: To evaluate the utility of the STEP model, a systematic hospital–school transition protocol for children hospitalized for TBI.

Setting: Five children’s hospitals in Colorado, Ohio, and Oregon.

Participants: Hundred families of children with mild, complicated mild, moderate, or severe TBI.

Design: Randomized controlled trial (RCT); participants were randomized while hospitalized to the STEP (a standardized hospital–school transition protocol for children treated for TBI) or usual care condition.

Main Measures: Questionnaire about child’s special education eligibility status, support services, and academic accommodations; Achenbach Child Behaviour Checklist (CBCL); Behaviour Rating Inventory of Executive Function (BRIEF); Child and Adolescent Scale of Participation (CASP); Child and Adolescent Scales of Environment (CASE)

Results: There were no significant effects, indicating that STEP participants did not differ from usual care participants on any study outcome at one month post-discharge or at one-year follow-up.

Conclusion: The lack of significant findings in this study does not imply that effective hospital-to-school transition programming is unnecessary. Rather, the findings raise important questions regarding timing and dosage/intensity of intervention, appropriate measurement of outcomes, and fidelity of programme delivery. The study highlights difficulties involved in the conduct of community-based RCTs in the paediatric TBI population.

KEYWORDS:

• Education
• brain injuries/*rehabilitation
• disabled children/*education
• child
• programme development
• programme evaluation
• surveys and questionnaires
• schools
• hospitals
• school health services

Acknowledgments

The authors thank Jeff Gau for his contribution to data analysis, and Laura Beck and Elizabeth Backus for their assistance with the preparation of the manuscript.

Declaration of interest

No conflicts were declared by any of the authors.

Additional information

Funding

This work was supported by the National Institute on Disability and Rehabilitation Research (now National Institute on Disability, Independent Living, and Rehabilitation Research) [grant number H133A060075].