Article

OBJECTIVE: To examine associations of clinical need, defined by elevated parent
ratings of child behavior problems and utilization of behavioral health services
in young children with traumatic brain injury (TBI) and an orthopedic injury (OI)
comparison group. DESIGN: Parents completed outcome measures 18 months after
injury and at an extended follow-up conducted an average of 38 months postinjury.
SETTING: Children's hospitals and a general hospital. PARTICIPANTS: Participants
included parents of 3 groups of children injured between 3 and 7 years of age
(N=139): 47 children with complicated mild to moderate TBI, 18 with severe TBI,
and 74 with OI. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Parents
completed ratings of child behavior, mental health symptomology, and family
functioning at both visits; at the extended follow-up, they reported utilization
of behavior therapy or counseling services since the 18-month follow-up visit.
RESULTS: Children with TBI had more behavior problems than those with OI.
Although clinical need at both follow-ups was associated with greater service
utilization at the extended follow-up, all groups had unmet needs as defined by a
clinical need in the absence of services. Lower socioeconomic status was
associated with higher rates of unmet need across groups. CONCLUSIONS: The
results document unmet long-term behavioral health needs after both TBI and OI in
children and underscore the importance of monitoring and treatment of postinjury
behavior problems.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS