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Home Environment as a Predictor of Long-Term Executive Functioning following Early Childhood Traumatic Brain Injury

Published online by Cambridge University Press:  20 July 2017

Christianne Laliberté Durish ,
Keith Owen Yeates ,
Terry Stancin ,
H. Gerry Taylor ,
Nicolay C. Walz  and
Shari L. Wade
Christianne Laliberté Durish*
Affiliation:
Department of Psychology, University of Calgary, Alberta Children’s Hospital Research Institute, Calgary, AB
Keith Owen Yeates
Affiliation:
Department of Psychology, University of Calgary, Hotchkiss Brain Institute, Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB
Terry Stancin
Affiliation:
Division of Child & Adolescent Psychiatry & Psychology, Department of Psychiatry, Case Western Reserve University and MetroHealth Medical Center, Cleveland, Ohio
H. Gerry Taylor
Affiliation:
Department of Pediatrics, Case Western Reserve University and Rainbow Babies and Children’s Hospital, University Hospitals Cleveland Medical Center, Cleveland, Ohio
Nicolay C. Walz
Affiliation:
Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati, Ohio
Shari L. Wade
Affiliation:
Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
*
Correspondence and reprint requests to: Christianne Laliberté Durish, Department of Psychology, University of Calgary, 2500 University Drive N.W., Calgary, Alberta, T2N 1N4. E-mail: christianne.lalibert@ucalgary.ca
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Abstract

Objectives: This study examined the relationship of the home environment to long-term executive functioning (EF) following early childhood traumatic brain injury (TBI). Methods: Participants (N=134) were drawn from a larger parent study of 3- to 6-year-old children hospitalized for severe TBI (n=16), complicated mild/moderate TBI (n=44), or orthopedic injury (OI; n=74), recruited prospectively at four tertiary care hospitals in the United States and followed for an average of 6.8 years post-injury. Quality of the home environment, caregiver psychological distress, and general family functioning were assessed shortly after injury (i.e., early home) and again at follow-up (i.e., late home). Participants completed several performance-based measures of EF at follow-up. Hierarchical regression analyses examined the early and late home environment measures as predictors of EF, both as main effects and as moderators of group differences. Results: The early and late home environment were inconsistent predictors of long-term EF across groups. Group differences in EF were significant for only the TEA-Ch Walk/Don’t Walk subtest, with poorer performance in the severe TBI group. However, several significant interactions suggested that the home environment moderated group differences in EF, particularly after complicated mild/moderate TBI. Conclusions: The home environment is not a consistent predictor of long-term EF in children with early TBI and OI, but may moderate the effects of TBI on EF. The findings suggest that interventions designed to improve the quality of stimulation in children’s home environments might reduce the long-term effects of early childhood TBI on EF. (JINS, 2018, 24, 11–21)

Keywords

PreschoolNeuropsychologyAttentionProblem solvingParentingfamily
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 24 , Issue 1 , January 2018 , pp. 11 - 21
Copyright
Copyright © The International Neuropsychological Society 2017 

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Appendix A

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