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Recovery Trajectories of Child and Family Outcomes Following Online Family Problem-Solving Therapy for Children and Adolescents after Traumatic Brain Injury

Published online by Cambridge University Press:  13 August 2019

Shari L. Wade ,
Allison P. Fisher ,
Eloise E. Kaizar ,
Keith O. Yeates ,
H. Gerry Taylor  and
Nanhua Zhang
Shari L. Wade*
Affiliation:
Division of Pediatric Rehabilitation Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
Allison P. Fisher
Affiliation:
Division of Pediatric Rehabilitation Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
Eloise E. Kaizar
Affiliation:
Department of Statistics, The Ohio State University, Columbus, OH 43210, USA
Keith O. Yeates
Affiliation:
Department of Psychology, Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
H. Gerry Taylor
Affiliation:
Center for Biobehavioral Health, Nationwide Children’s Hospital Research Institute, Columbus, OH 43205-2664, USA
Nanhua Zhang
Affiliation:
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
*
*Correspondence to: Shari L Wade, Professor, Division of Pediatric Rehabilitation Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA. E-mail: [email protected]
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Abstract

Objectives: We conducted joint analyses from five randomized clinical trials (RCTs) of online family problem-solving therapy (OFPST) for children with traumatic brain injury (TBI) to identify child and parent outcomes most sensitive to OFPST and trajectories of recovery over time. Methods: We examined data from 359 children with complicated mild to severe TBI, aged 5–18, randomized to OFPST or a control condition. Using profile analyses, we examined group differences on parent-reported child (internalizing and externalizing behavior problems, executive function behaviors, social competence) and family outcomes (parental depression, psychological distress, family functioning, parent–child conflict). Results: We found a main effect for measure for both child and family outcomes [F(3, 731) = 7.35, p < .001; F(3, 532) = 4.79, p = .003, respectively], reflecting differing degrees of improvement across measures for both groups. Significant group-by-time interactions indicated that children and families in the OFPST group had fewer problems than controls at both 6 and 18 months post baseline [t(731) = −5.15, p < .001, and t(731) = −3.90, p = .002, respectively, for child outcomes; t(532) = −4.81, p < .001, and t(532) = −3.80, p < .001, respectively, for family outcomes]. Conclusions: The results suggest limited differences in the measures’ responsiveness to treatment while highlighting OFPST’s utility in improving both child behavior problems and parent/family functioning. Group differences were greatest at treatment completion and after extended time post treatment.

Keywords

PediatricBrain injuryBehaviorTreatmentRandomized controlled trialParentProfile analysis
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 25 , Issue 9 , October 2019 , pp. 941 - 949
Copyright
Copyright © INS. Published by Cambridge University Press, 2019. 

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