The clinical utility of the Children’s Communication Checklist-2 in children with early childhood traumatic brain injury

Abstract

Objective

Pediatric traumatic brain injury (TBI) is associated with long-term cognitive and behavioral deficits. Social communication impairments are common and impact functional outcomes, such as social engagement and academic performance. There are many barriers to identifying social communication deficits following TBI, including the absence of a standardized parent-reported communication measure for use in this population. The Children’s Communication Checklist—Second Edition (CCC-2) has demonstrated utility in identifying communication deficits in diagnoses other than TBI. This study investigated the clinical utility of the CCC-2’s social communication scales in children with TBI. Method: 203 children who sustained TBI or orthopedic injuries between the ages of 36 and 83 months were recruited as part of a larger, longitudinal study. We analyzed social communication subscale scores from the CCC-2 an average of 3.5 years postinjury. We used binary logistic regression analyses to examine the measure’s accuracy in classifying children with and without social communication deficits on other measures of pragmatic language and social competence. Correlation analyses and linear mixed models were used to examine the construct validity of the CCC-2. Results: The CCC-2 was able to accurately classify those with and without pragmatic language impairments on the Comprehensive Assessment of Spoken Language 92% of the time (sensitivity = 55%) and 96% of the time on the Home and Community Social Behavior scale (sensitivity = 72%). The CCC-2 demonstrated strong correlations with and predictive validity for measures of social communication and competence. Conclusions: The findings offer support for the clinical utility of the CCC-2 in the pediatric TBI population.

Keywords:

• Traumatic brain injury
• social communication
• communication deficits
• Children’s Communication Checklist
• parent-report measures
• neuropsychological measures
• pediatric

Acknowledgements

We acknowledge the contributions of The Cincinnati Children’s Medical Center Trauma Registry, Rainbow Pediatric Trauma Center, Rainbow Babies & Children’s Hospital, Nationwide Children’s Hospital Trauma Program, and MetroHealth Center Department of Pediatrics and Trauma Registry with the original recruitment of participants.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This publication was supported by Grant R01 HD42729 from the National Institute of Child Health and Human Development and by Trauma Research grants from the State of Ohio Emergency Medical Services. Additional support was provided through Grant 8 UL1 TR000077 from the National Center for Advancing Translational Sciences of the National Institutes of Health.