Date of Award

Fall 12-1-2004

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Educational and School Psychology

First Advisor

Michael W. Bahr

Second Advisor

P. G. Aaron

Third Advisor

Martha Simcox

Abstract

Children and adolescents with a traumatic brain injury (TBI) were the focus of this investigation using an extant data set. The 3 7 participants were between the ages of 5 and 15 years at the time of injury, and the majority had a severe TBI. Participants were evaluated soon after injury for a Baseline description of functioning on measures of cognition and memory and re-evaluated at one and/or two year return appointments. Parents provided estimates of adaptive, internalizing, and externalizing behaviors at Baseline and at follow-up appointments on the V ABS and CBCL. It was expected that parents' descriptions of their child's behaviors would deteriorate across time as prior research suggests an increased incidence of emotional and behavioral problems in the years following TBI and clinical observations suggest that parents need a period of adjustment prior to recognizing or acknowledging behavioral difficulties. Parents' descriptions of their child's externalizing behaviors did not change over time and were always within normative expectations. Adaptive . behavior, particularly socialization skills, improved over the follow-up period. A correlation analysis did not find the expected relationship between working memory . and externalizing behaviors. In spite of prior research suggesting that children with more severe injuries had more externalizing behaviors that worsened over time, relative to those with less severe injuries, an ANOVA failed to find main effects or interaction effects for time after injury by severity of injury. One implication of the study's unexpected results is that, despite a review of published studies to the contrary, there may be reason for cautious optimism when counseling parents regarding their child's behavioral recovery following TBI. The continuing development of published instruments measuring aspects of working memory and parent and teacher observations of behavior may provide future insight into the recovery of children following TBI.

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