Developmental Consequences of Pediatric TBI

儿童 TBI 的发育后果

• 批准号: 8539285
• 负责人: LINDA EWING-COBBS
• 金额: $ 48.41万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-30 至 2017-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8539285
• 关键词: Developmental; Consequences; Pediatric; TBI

DESCRIPTION (provided by applicant): Traumatic brain injury leaves 17,000 children disabled yearly. Many children do not achieve their expected developmental trajectory after injury. Services exist for children with specific developmental disorders when they are known to be at risk for delays; however, children with traumatic brain injury frequently do not access these services. The overall goal of this project is to understand how traumatic brain injury affects children's development. This project is a longitudinal, prospective cohort study of children 0 to 15 years of age with all severities of traumatic brain injury. Children with traumatic brain injury and a comparison group of age and sex- matched children with orthopedic injury will be recruited from the two participating institutions. Specifically, the aims of this project are to fist characterize this cohort of children and age and sex matched orthopedic injury comparison children in relation to acute, post-acute and longer term treatments. We will characterize the children's family environment and cognitive and socio-emotional reserve as these may influence changes in children's short and longer term health status. Then, we will measure health specific outcomes during the first year after injury, including physical health, post-concussion symptoms, and stress. We will assess children's longer term developmental progress using growth curve analysis of key neuropsychological domains including cognition, social, and psychological health outcomes compared to children with orthopedic injuries. We will then use structural equation modeling to examine the relationships of injury severity, family environment, and neuropsychological status on children's ability to participate in everyday activities and perform i school. Finally, we will quantify children's health service use and health care costs for the year following injury. Results of this research will help to understand the complex interactions of preinjury family and child characteristics, post injury child deficits and family stress on childre's developmental outcomes. This information will be integrated with the children's current health service and school support service use in order to understand the barriers to services and inform the needed supports for children at each developmental stage.

描述（由申请人提供）： 创伤性脑损伤每年导致 17,000 名儿童残疾。许多儿童在受伤后没有达到预期的发育轨迹。当已知患有特定发育障碍的儿童有发育迟缓的风险时，可以为他们提供服务；然而，患有脑外伤的儿童通常无法获得这些 服务。该项目的总体目标是了解创伤性脑损伤如何影响儿童的发育。该项目是一项针对 0 至 15 岁各种严重程度的脑外伤儿童的纵向、前瞻性队列研究。患有脑外伤的儿童 将从两个参与机构中招募年龄和性别匹配的骨科损伤儿童作为对照组。具体来说，该项目的目的是首先描述这组儿童以及年龄和性别匹配的骨科损伤比较儿童与急性、急性后和长期治疗的关系。我们将描述儿童的家庭环境以及认知和社会情感储备的特征，因为这些可能会影响儿童短期和长期健康状况的变化。然后，我们将衡量受伤后第一年的健康具体结果，包括身体健康、脑震荡后症状和压力。我们将使用关键神经心理学领域的生长曲线分析来评估儿童的长期发育进展，包括与骨科损伤儿童相比的认知、社会和心理健康结果。然后，我们将使用结构方程模型来检查伤害严重程度、家庭环境和神经心理状态与儿童参与日常活动和在学校的能力之间的关系。最后，我们将量化受伤后一年的儿童医疗服务使用情况和医疗保健费用。这项研究的结果将有助于了解受伤前家庭和儿童特征、受伤后儿童缺陷和家庭压力对儿童发育结果的复杂相互作用。这些信息将与儿童当前的健康服务和学校支持服务的使用相结合，以了解服务的障碍并告知儿童在每个发展阶段所需的支持。