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. 2017 Jul;31(5):486-498.
doi: 10.1037/neu0000325.

Long-term classroom functioning and its association with neuropsychological and academic performance following traumatic brain injury during early childhood

Amery Treble-Barna  1 , Hanna Schultz  1 , Nori Minich  2 , H Gerry Taylor  2 , Keith Owen Yeates  3 , Terry Stancin  2 , Shari L Wade  4
Affiliations

Long-term classroom functioning and its association with neuropsychological and academic performance following traumatic brain injury during early childhood

Amery Treble-Barna et al. Neuropsychology. 2017 Jul.

Abstract

Objective: The present study utilized ecobehavioral assessment to examine classroom functioning several years following early childhood traumatic brain injury (TBI) or orthopedic injury (OI) and its association with injury factors, neuropsychological abilities, and academic performance.

Method: Participants included 39 children with moderate to severe TBI and 51 children with OI sustained between ages 3 and 7 years. At 7.2 (± 1.3) years post injury, ecobehavioral assessment was used to examine classroom functioning. Additional outcomes included neuropsychological tests, parent and teacher ratings of dysexecutive behavior, and teacher ratings of academic performance. Groups were compared on measures controlling for demographic characteristics, and associations among outcomes were examined using linear regression.

Results: Children with TBI showed lower academic engagement relative to children with OI, as well as more frequent individual teacher attention for children with more severe injuries. For children with TBI, difficulties in classroom functioning were associated with lower cognitive flexibility and higher parent and teacher ratings of dysexecutive behavior. Lower scores on a test of fluid reasoning and a greater frequency of individual teacher attention were also associated with lower academic performance in children with TBI.

Conclusions: Difficulties in classroom functioning are evident several years after early childhood TBI and were associated with greater injury severity, neuropsychological weaknesses, and poorer academic performance. Children with impaired cognitive flexibility and fluid reasoning skills were at greatest risk for these difficulties and associated weaknesses in academic performance. Instructional interactions may be a potential target for intervention to promote academic progress in at-risk children. (PsycINFO Database Record

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Figures

Figure 1
Figure 1
Associations of Classroom Functioning and Neuropsychological Performance by Injury Group. The y axis indicates the frequency (percent of 1-minute cycles) of occurrence of the behavior during the observational session. High and low levels of the predictor (x axis) are based on 1 standard deviation above or below the sample mean. Higher BRIEF GEC indicates more frequent dysexecutive behaviors. Higher TEA-Ch scores indicate better performance. BRIEF GEC = Behavior Rating Inventory of Executive Function Global Executive Composite; OI = orthopedic injury; TBI = traumatic brain injury; TEA-Ch = Test of Everyday Attention for Children.
Figure 2
Figure 2
Association of Academic Performance and WASI Matrix Reasoning by Injury Group. High and low levels of WASI Matrix Reasoning are based on 1 standard deviation above or below the sample mean. Higher WASI Matrix Reasoning scores indicate better performance. OI = orthopedic injury; TBI = traumatic brain injury; WASI = Wechsler Abbreviated Scale of Intelligence.
Figure 3
Figure 3
Association of Academic Performance and Teacher Focus on Target by Injury Group. High and low levels of Sqrt. Teacher focus on target are based on 1 standard deviation above or below the sample mean. Higher Sqrt. Teacher focus on target indicates more frequent individual teacher attention to the child being observed. OI = orthopedic injury; TBI = traumatic brain injury.
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