TBI Predisposes Kids To Attention Deficit Problems, Even Years After Injury

MedicalResearch.com Interview with:
Dr. Megan E. Narad, PhD

Division of Behavioral Medicine and Clinical Psychology
Cincinnati Children’s Hospital Medical Center | CCHMC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previous research has shown that children with a history of traumatic brain injury (TBI) demonstrate difficulties with attention following injury; however, most studies only follow children 2-3 years after injury. Our study followed a group of children with a history of TBI 7-10 years after injury.

The main finding is that those with severe TBI were at greater risk for developing secondary attention deficit hyperactivity disorder (SADHD) than those with orthopedic injury; however, it should also be noted that kids with less severe injuries were also at risk of developing SADHD. In addition to injury severity, environmental factors (maternal education and family functioning) also played a role in SADHD development. It should also be noted that a number of kids developed SADHD >3.5 years after injury suggesting that these difficulties may not surface until many years after injury.

MedicalResearch.com: What should readers take away from your report?

Response: The main take home message is that children with a history of TBI, even those with less severe injuries have an increased risk for the development of new-onset attention problems, potentily many years after injury. While previous studies have shown that kids with a history of TBI are at risk for developing attention problems, they only followed kids 2-3 years after injury. Our study is unique in that we followed children 7-10 years after their injury, and demonstrated that some kids develop attention problems many years after injury. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Further understanding how to identify who is at greatest risk for development of persistent attention problems following injury will be important. Although treatments were not the focus of the study, a critical need exists to evaluate the effectiveness of interventions for attention problems after pediatric traumatic brain injury , including medications and cognitive training. A better understanding of how a range of factors predicts the development of attention problems after TBI would inform delivery of interventions in the most timely and effective manner. 

Disclosures: This publication was supported by grant R01HD42729 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and a Trauma Research Grant from the State of Ohio Emergency Medical Services. Additional support was provided through grant 8 UL1TR000077 from the National Center for Advancing Translational Sciences of the National Institutes of Health, grant 1F32HD088011-01 from NICHD, grant K23 HD07468303 from NICHD, and the Rehabilitation Research Experience for Medical Students.

Citations:

Narad ME, Kennelly M, Zhang N, Wade SL, Yeates KO, Taylor HG, Epstein JN, Kurowski BG. Secondary Attention-Deficit/Hyperactivity Disorder in Children and Adolescents 5 to 10 Years After Traumatic Brain Injury. JAMA Pediatr. Published online March 19, 2018. doi:10.1001/jamapediatrics.2017.5746

 

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