Longitudinal Investigation of the Post—High School Transition Experiences of Adolescents With Traumatic Brain Injury

Objective:To describe outcomes for youth with traumatic brain injury (TBI) transitioning from high school to adulthood. Design:Longitudinal design using univariate and multivariate analyses, including survival analysis to predict time to outcomes of interest and longitudinal growth modeling to evaluate factors that predict rates and levels of outcomes over time. Main Outcome Measures:employment, post–secondary education, and independent living status. Participants:Eighty-nine youth and young adults (aged 19–25 years) with TBI (19 mild–moderate TBI and 70 severe TBI). Results:Individuals entering adulthood following childhood TBI experienced fluctuations in rates of employment, enrollment in post–secondary education, and independent living. A higher likelihood of being enrolled in post–secondary education following graduation from high school was associated with being female, later age at injury, and higher socioeconomic status. Overall greater likelihood of employment was associated with higher socioeconomic status, while employment upon high school graduation was associated with more severe injury and lack of rehabilitations services. Greater likelihood of independent living was associated with later age at injury and nonreceipt of rehabilitation services, while shorter time until independent living was associated with less severe injury. Conclusion:Knowledge of how specific factors affect transition outcomes can be used to tailor transition interventions and resources to the needs of students with TBI. Findings related to special education and medical rehabilitation services should be interpreted with caution as the criteria for receipt of both types of services and the links between such services and functional outcomes are unclear.

[1]  T. Weisner,et al.  An Ecocultural Perspective on Risk and Protective Factors in Children's Development: Implications for Learning Disabilities. , 1993 .

[2]  M. Sainio,et al.  Middle age cognition and vocational outcome of childhood brain injury , 2005, Acta neurologica Scandinavica.

[3]  D. Drotar,et al.  Short- and long-term social outcomes following pediatric traumatic brain injury , 2004, Journal of the International Neuropsychological Society.

[4]  G. Gioia,et al.  TEST REVIEW Behavior Rating Inventory of Executive Function , 2000 .

[5]  L. Jarho,et al.  Long-term outcome after severe brain injury in preschoolers is worse than expected. , 1996, Archives of pediatrics & adolescent medicine.

[6]  I. Emanuelson,et al.  Cognitive outcome in children and young adults who sustained severe and moderate traumatic brain injury 10 years earlier , 2009, Brain injury.

[7]  D. Drotar,et al.  Health-related quality of life of children and adolescents after traumatic brain injury. , 2002, Pediatrics.

[8]  N. Polissar,et al.  Family functioning and children's academic performance and behavior problems in the year following traumatic brain injury. , 1994, Archives of physical medicine and rehabilitation.

[9]  N. Polissar,et al.  Outcome of pediatric traumatic brain injury at three years: a cohort study. , 1994, Archives of physical medicine and rehabilitation.

[10]  A. B. Hollingshead,et al.  Four factor index of social status , 1975 .

[11]  D. Drotar,et al.  Influences on first-year recovery from traumatic brain injury in children. , 1999, Neuropsychology.

[12]  B. Dijcks,et al.  Long-term neuropsychological performance in a cohort of children and adolescents after severe paediatric traumatic brain injury , 2006, Brain injury.

[13]  R Brianti,et al.  Traumatic brain injury in childhood: intellectual, behavioural and social outcome into adulthood. , 1998, Brain injury.

[14]  A. Halpern.  The Transition of Youth with Disabilities to Adult Life: A Position Statement of the Division on Career Development and Transition, The Council for Exceptional Children , 1994 .

[15]  Mary Wagner,et al.  Longitudinal Postschool Outcomes of Youth with Disabilities: Findings from the National Longitudinal Transition Study , 1996 .

[16]  S. Chapman,et al.  Predictors of personality change due to traumatic brain injury in children and adolescents six to twenty-four months after injury. , 2006, The Journal of neuropsychiatry and clinical neurosciences.

[17]  E. J. Hart,et al.  Neurobehavioral outcome after closed head injury in childhood and adolescence. , 1987, Archives of neurology.

[18]  N. Polissar,et al.  Recovery trends over three years following pediatric traumatic brain injury. , 1995, Archives of physical medicine and rehabilitation.

[19]  J. Rosenfeld,et al.  Recovery of memory function following traumatic brain injury in pre-school children. , 2000, Brain injury.

[20]  D. Hogan,et al.  School-to-work program participation and the post-high school employment of young adults with disabilities. , 2008, Journal of vocational rehabilitation.

[21]  Ayala Lusky,et al.  Epidemiological, clinical, and microbiological characteristics of late-onset sepsis among very low birth weight infants in Israel: a national survey. , 2002, Pediatrics.

[22]  Phyllis Levine,et al.  After High School: A First Look at the Postschool Experiences of Youth with Disabilities. A Report from the National Longitudinal Transition Study-2 (NLTS2). , 2005 .

[23]  D. Francis,et al.  Longitudinal neuropsychological outcome in infants and preschoolers with traumatic brain injury , 1997, Journal of the International Neuropsychological Society.

[24]  Laurence E. Lynn,et al.  Means and Ends: A Comparative Study of Empirical Methods For Investigating Governance and Performance , 2001 .

[25]  I. Emanuelson,et al.  Neuropsychological progress during 14 years after severe traumatic brain injury in childhood and adolescence , 2004, Brain injury.

[26]  G. Gioia,et al.  TEST REVIEW Behavior Rating Inventory of Executive Function , 2000 .

[27]  T Nybo,et al.  Cognitive indicators of vocational outcome after severe traumatic brain injury (TBI) in childhood. , 1999, Brain injury.

[28]  V. Anderson,et al.  The impact of injury severity on long-term social outcome following paediatric traumatic brain injury , 2009, Neuropsychological rehabilitation.

[29]  N. Polissar,et al.  Family functioning and injury severity as predictors of child functioning one year following traumatic brain injury. , 1993, Archives of physical medicine and rehabilitation.

[30]  Z. Groswasser,et al.  Long-term follow-up review of 31 children with severe closed head trauma. , 1990, Journal of neurosurgery.

[31]  Denise L. Drane,et al.  Service Utilization following Traumatic Brain Injury , 2000, The Journal of head trauma rehabilitation.

[32]  S. Warschausky,et al.  Neurobehavioral Outcomes After Early Versus Late Childhood Traumatic Brain Injury , 2007, The Journal of head trauma rehabilitation.

[33]  P. Yovanoff,et al.  The Importance of Getting Started Right , 2004 .

[34]  M. Rutter.  Studies of psychosocial risk : the power of longitudinal data , 1988 .

[35]  B. Jennett,et al.  Assessment of coma and impaired consciousness. A practical scale. , 1974, Lancet.

[36]  Arnstein Finset, Stein Andersson.  Coping strategies in patients with acquired brain injury: relationships between coping, apathy, depression and lesion location , 2000, Brain injury.

[37]  G. Whiteneck,et al.  Cost of medical care for a population-based sample of persons surviving traumatic brain injury , 1995 .

[38]  L. Eisenman,et al.  Theories in Practice: School-to-Work Transitions-for-Youth With Mild Disabilities , 2003 .

[39]  V. Nell,et al.  Epidemiology of traumatic brain injury in Johannesburg--II. Morbidity, mortality and etiology. , 1991, Social science & medicine.

[40]  P. Yovanoff,et al.  Life on the “Outs”—Examination of the Facility-to-Community Transition of Incarcerated Youth , 2002 .

[41]  R. Lyons,et al.  Modification of the home environment for the reduction of injuries. , 2011, The Cochrane database of systematic reviews.

[42]  B. Todis,et al.  Redefining Success: Results of a Qualitative Study of Postsecondary Transition Outcomes for Youth With Traumatic Brain Injury , 2008, The Journal of head trauma rehabilitation.

[43]  Clifford Goodman,et al.  American Academy of Physical Medicine and Rehabilitation , 1988 .

[44]  F. Rivara,et al.  Association between injury indices and outcome after severe traumatic brain injury in children. , 1996, Archives of physical medicine and rehabilitation.

[45]  C. Hawley,et al.  Return to school after brain injury , 2004, Archives of Disease in Childhood.

[46]  Keith Owen Yeates,et al.  Long-term behavior problems following pediatric traumatic brain injury: prevalence, predictors, and correlates. , 2003, Journal of pediatric psychology.

[47]  D. Drotar,et al.  Family Burden and Adaptation During the Initial Year After Traumatic Brain Injury in Children , 1998, Pediatrics.

[48]  V. Anderson,et al.  Educational, Vocational, Psychosocial, and Quality‐of‐Life Outcomes for Adult Survivors of Childhood Traumatic Brain Injury , 2009, The Journal of head trauma rehabilitation.

[49]  L. Krach,et al.  Severe adolescent head injury: implications for transition into adult life. , 1988, Pediatric neurology.

[50]  Andrew Smolen,et al.  The National Longitudinal Study of Adolescent Health (Add Health) Sibling Pairs Data , 2012, Twin Research and Human Genetics.