Published April 2016
JAMA Pediatrics

Improving parenting skills and home environments could help more children overcome the longer-term effects of traumatic brain injury (TBI).

That’s the conclusion of a study comparing long-term outcomes of 58 children who suffered TBIs with 72 children who sustained orthopaedic injuries (OI). Shari Wade, PhD, director of research, Division of Physical Medicine and Rehabilitation, led the project.

The study found that children with moderate and severe TBIs had more impairments in multiple domains nearly seven years after their injury than the OI group. Children with complicated mild TBIs also had more school and thinking impairments than the OI group.

The study builds on Wade’s previous research about how a child’s social environment can affect recovery from TBI. It explores the use of online problem-solving therapy and family intervention programs to improve an injured child’s success.

The latest research encompassed observations performed from January 2010 through April 2015 at schools, homes and at four participating Midwest hospitals. The team used the Child and Adolescent Functional Assessment Scale (CAFAS) to measure outcomes.

Wade and colleagues found that more-pronounced impairments in behavior and academic performance occurred among children in homes where parenting styles were either highly permissive or authoritative. Impairment levels also were elevated in homes with access to fewer resources.

“Even children with relatively mild early TBI experience long-term functional impairments, particularly in the context of less favorable home environments,” says Wade. “These findings suggest that improving parenting skills and the quality of the home environment may promote functional recovery following early TBI.”