Participation seven years after severe childhood traumatic brain injury

Hugo Câmara-Costa (1, 2) , Leila Francillette (2) , Marion Opatowski (3) , Hanna Toure (4) , Dominique G. Brugel (4) , Anne S. Laurent-Vannier (4) , Philippe Gabriel Meyer (5, 6) , Georges Dellatolas (1) , Laurence Watier (3) , Mathilde P. Chevignard (2, 4)

1 CESP - Centre de recherche en épidémiologie et santé des populations
2 LIB - Laboratoire d'Imagerie Biomédicale [Paris]
3 B2PHI - Biostatistique, Biomathématique, Pharmacoépidémiologie et Maladies Infectieuses
4 Service de Rééducation des pathologies neurologiques acquises de l'enfant [Hôpitaux de Saint Maurice]
5 Hôpital Necker - Enfants Malades [AP-HP]
6 UFR Médecine UPCité - UFR Médecine [Santé] - Université Paris Cité

Purpose: Participation in home, school and community activities is considered as the ultimate aim of rehabilitation. The aims of this study were to examine participation seven years post-severe childhood traumatic brain injury and factors associated with participation. Materials and methods: Participants were enrolled in the Traumatisme Grave de l’Enfant (Severe Childhood Injury) cohort study following severe accidental childhood traumatic brain injury. Participation seven years post-injury, was examined using parent- and self-report forms of the Child and Adolescent Scale of Participation among 37 patients [62% males, mean age 15.4 years (SD = 4.4), mean length of coma 6.68 days (SD = 4.96)] and 33 matched controls. Results: Parent reports indicated significantly lower participation among patients compared to controls, but the self-reports did not. In the traumatic brain injury group, parent-reported participation was variable, with 22% of the patients clearly showing greater restrictions than controls. Participation restrictions were significantly associated with injury severity, poor functional outcome one-year post-injury, executive and behavioral difficulties and higher fatigue levels seven years post-injury, but not with pre-injury nor family factors. Conclusions: Several years after severe childhood traumatic brain injury, participation appears to depend more on injury-related factors than on environmental factors. In self-reports assessments of participation, it could be difficult for children and adolescents to distinguish capacity from performance.

Mots clés: child; outcome; Participation; prospective cohort study; severe traumatic brain injury; participation

Domaines: Sciences du Vivant [q-bio]

Hugo Câmara-Costa, Leila Francillette, Marion Opatowski, Hanna Toure, Dominique G. Brugel, et al.. Participation seven years after severe childhood traumatic brain injury. Disability and Rehabilitation, 2020, 42 (17), pp.2402-2411. ⟨10.1080/09638288.2019.1594398⟩. ⟨hal-02938403⟩