CO033
Troubles du comportement à 7 ans d’un traumatisme crânien sévère de l’enfant :
Résultats de l’étude Traumatisme Grave de l’Enfant (TGE)
Hugo
Câmara Costa
(Paris, France),
Lilia
Tokpo
(Saint Maurice, France),
Leila
Francillette
(Saint Maurice, France),
Hanna
Toure
(Saint Maurice, France),
Dominique
Brugel
(Saint Maurice, France),
Anne
Laurent-Vannier
(Saint Maurice, France),
Philippe
Meyer
(Paris, France),
Georges
Dellatolas
(Paris, France),
Mathilde
Chevignard
(Saint Maurice, France)
Objective :
To investigate the occurrence of behavioral problems 7-years after severe pediatric Traumatic Brain Injury in the Traumatisme Grave de l’Enfant (TGE) longitudinal cohort, and their evolution from 3 months to 7-years post-injury.
Material / Patients and Methods :
Thirty-four participants [38% girls, mean (SD) age at injury 7.6 (4.7) years, age at assessment 15 (4.6) years] underwent comprehensive assessment 7-years after severe TBI, and were matched to a control group by age, gender and parental education level. A sub-group of 20 participants had available behavioral assessments at 3-, 12- and 24-months post-injury. Behavioral problems were assessed using self- and parent-reports of the Achenbach’s Behavioral Checklist. Additional data included sociodemographic background, initial injury severity, and specific outcomes assessed concurrently 7-years post-injury.
Results :
Compared to controls: 1) a significant proportion of participants with severe TBI fell above the clinical cut-off for self- (42%) and parent-reported (36%) Externalizing problems, but not for self- (33%) or parent-reported (45%) Internalizing problems; 2) Withdrawn/Depressed, Intrusive behavior and Somatic complaints were significantly higher in self-reports; 3) Rule-breaking behavior, Attention and Social problems were significantly higher in parent-reports. Parent-reports of Externalizing problems were significantly associated with greater injury severity and with greater concurrent overall disability, lower intellectual ability, participation and quality of life, increased levels of fatigue and poorer family functioning. There was a tendency of parent-reported behavioral problems to increase over time between 3-months and 7-years post-injury.
Discussion - Conclusion :
These results highlight the importance of long-term follow-up and individualized interventions for children who underwent severe TBI, as issues can arise over time.
Keywords :
Severe traumatic brain injury, children, adolescents, longitudinal study, behavioral problems.