Cognitive recovery of children and adolescents with moderate to severe TBI during inpatient rehabilitation

Abstract

Objective

Traumatic brain injury (TBI) is the leading cause of morbidity and mortality in children and adolescents. This study examines the early cognitive-linguistic recovery of pediatric patients who sustained TBI and required inpatient rehabilitation and investigates the contribution of various demographic, clinical, and preinjury factors to recovery.

Methods

A retrospective chart review of children and adolescents, ages 3–20 years, admitted to an inpatient rehabilitation unit. Acute outcomes were assessed at admission and discharge using the WeeFIM and CALS. Premorbid measures of behavioral and emotional functioning were also collected.

Results

One hundred and one children and adolescents (mean age = 12.31, SD = 4.46) diagnosed with TBI requiring inpatient rehabilitation were included. Patients displayed significant improvements on cognitive-linguistic skills and functional independence between admission and discharge, with medium to large effect sizes. Premorbid behavioral-emotional functioning was not found to be associated with early cognitive recovery.

Conclusion

Results suggest that significant functional improvements can be expected for pediatric patients with TBI during inpatient rehabilitation. Consistent with previous literature, injury severity was significantly related to acute outcomes. In conjunction with the WeeFIM, the CALS appears to be a meaningful complement for assessing and monitoring cognitive-linguistic skills during inpatient rehabilitation.

Implications for Rehabiliation

• Our study provides support for the utility of the CALS to assess cognitive recovery during inpatient rehabilitation following moderate to severe TBI.

• Injury severity and not pre-injury functioning or demographic variables was related to worse scores on the CALS at discharge.

• Using a measure sensitive to change over admission, such as the CALS, can inform treatment planning.

Keywords:

• Adolescent
• child
• cognition
• recovery of function
• rehabilitation
• traumatic brain injury (TBI)

Acknowledgements

The authors thank Dr. Beth Slomine for mentorship and guidance in writing this manuscript. In addition, the authors thank the following students and staff for their contribution to the data collection and entry for this project: Sarah Watts, Alyssa Krentzel, and Sarah Morris.

Disclosure statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.