Later is Better for Post-TBI Training Interventions

Published December 2018 | Pediatrics

A metadata analysis of family and patient interventional training after pediatric traumatic brain injury (TBI) confirms what researchers have heard anecdotally: training is more effective when provided later than earlier in the child’s recovery.

The study analyzed five trials involving 359 children, ages 5-18, who had been hospitalized for moderate-to severe traumatic brain injury in the previous 24 months. Researchers found that online family problem-solving treatment (OFPST), which included therapist-led Skype sessions and access to self-guided, subject-specific information, was not as effective when implemented too soon after injury, hospitalization and discharge.

“We now have some very helpful data saying that delaying OFPST until the child is 6 months beyond the inj-ry is probably more effective,” says Shari Wade, PhD, the division’s director of research. “Later introduction of family-centered treatment is likely to be associated with greater improvements in external problems and executive dysfunction.”

Little is lost by delaying treatment until six months after a child’s injury, she says, an interval that gives injured brains time to heal and children, parents and families time to regain a sense of normalcy.

“We’d often hear comments from parents who said they felt they were in a fog, or that the training would have been more effective if they’d had more time to deal with all the other issues related to their child’s TBI,” Wade says.

Based on the study’s results, the division is delaying interventional training programs for up to six months after a child’s injury and continuing to investigate optimal interventional timing with support from an innovation grant and an Ohio Third Frontier grant.