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Stability of vocational outcome in adulthood after moderate to severe preschool brain injury

Published online by Cambridge University Press:  01 September 2004

TAINA NYBO
Affiliation:
Finnish Institute of Occupational Health, Helsinki, Finland
MARKKU SAINIO
Affiliation:
Finnish Institute of Occupational Health, Helsinki, Finland
KITI MÜLLER
Affiliation:
Finnish Institute of Occupational Health, Helsinki, Finland

Abstract

We studied how moderate to severe childhood traumatic brain injury (TBI) affects vocational outcome with time. This is the second follow-up of patients who were injured as preschoolers in traffic accidents. In the first follow-up the mean age was 23 years and in the present study the average age of the 27-patient cohort was 40 years. Twenty-two patients were assessed clinically by a neuropsychologist, neurologist and a social worker. Five patients, although not able or willing to participate in the clinical study, were contacted by telephone and interviewed on their vocational outcome. Compared to the first follow-up, 20/27 patients in total had no change in their vocational status. Nine out of the 27 patients were working full-time, two had subsidized jobs and 16 were not working. Twenty-four of 27 patients were independent in daily living. In the neuropsychological tests of executive functions, preserved flexibility associated with full-time work status. In conclusion, 1/3 of the patients were still employed full-time over 30 years after the TBI. This suggests that favorable vocational outcome, reached by young adulthood, is maintained at least until middle age. (JINS, 2004, 10, 719–723.)

Type
Research Article
Copyright
2004 The International Neuropsychological Society

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References

REFERENCES

Anderson, V., Morse, S., Klug, G., Catroppa, C., Haritou, F., Rosenfeld, J., & Pentland L. (1997). Predicting recovery from head injury in young children: A prospective analysis. Journal of the International Neuropsychological Society, 3, 568580.Google Scholar
Army Individual Test Battery. (1944). Manual of direction and scoring. Washington, DC: War Department, Adjutant General's Office.
Asikainen, I., Kaste, M., & Sarna, S. (1996). Patients with traumatic brain injury referred to a rehabilitation and re-employment programme: Social and professional outcome for 508 Finnish patients 5 or more years after injury. Brain Injury, 10, 883899.CrossRefGoogle Scholar
Bush, K., Kivlahan, D.R., McDonell, M.B., Fihn, S.D., & Bradley, K.A. (1998). The AUDIT alcohol consumption questions (AUDIT-C): An effective brief screening test for problem drinking. Archives of Internal Medicine, 158, 17891795.CrossRefGoogle Scholar
CANTAB. (1999). Cambridge Neuropsychological Test Automated Battery (CANTAB). Cambridge, UK: CeNeS Limited.
Emanuelson, I., von Wendt, L., Becklund, E., & Hagberg, I. (1998). Late outcome after severe traumatic brain injury in children and adolescents. Pediatric Rehabilitation, 2, 6570.CrossRefGoogle Scholar
Ewing-Cobbs, L., Fletcher, J.M., Levin, H.S., Francis, DJ., Davidson, K., & Miner, M.E. (1997). Longitudinal neuropsychological outcome in infants and preschoolers with traumatic brain injury. Journal of the International Neuropsychological Society, 3, 581591.Google Scholar
Heaton, R. (1981). Wisconsin Card Sorting Test manual. Odessa, FL: Psychological Assessment Resources.
Klein, M., Houx, P.J., & Jolles, J. (1996). Long-term persisting cognitive sequelae of traumatic brain injury and the effect of age. Journal of Nervous and Mental Diseases, 184, 459467.CrossRefGoogle Scholar
Klonoff, H., Clark, C., & Klonoff, P.S. (1993). Long-term outcome of head injuries: A 23 year follow up study of children with head injuries. Journal of Neurology, Neurosurgery and Psychiatry, 56, 410415.CrossRefGoogle Scholar
Koskiniemi, M., Kyykkä, T., Nybo, T., & Jarho, L. (1995). Long-term outcome after severe brain injury in preschoolers is worse than expected. Archives of Pediatric and Adolescent Medicine, 149, 249254.CrossRefGoogle Scholar
Max, J.E., Roberts, M.A., Koele, S.L., Lindgren, S.D., Robin, D.A., Arndt, S., Smith, W.L., Jr., & Sato, Y. (1999). Cognitive outcome in children and adolescents following severe traumatic brain injury: Influence of psychosocial, psychiatric, and injury-related variables. Journal of the International Neuropsychological Society, 5, 5868.Google Scholar
McKinlay, A., Dalrymple-Alford, J.C., Horwood, L.J., & Fergusson, D.M. (2002). Long term psychosocial outcomes after mild head injury in early childhood. Journal of Neurology, Neurosurgery and Psychiatry, 73, 281288.CrossRefGoogle Scholar
Nybo, T. & Koskiniemi, M. (1999). Cognitive indicators of vocational outcome after severe traumatic brain injury (TBI) in childhood. Brain Injury, 13, 759766.Google Scholar
Olver, J.H., Ponsford, J.L., & Curran, C.A. (1996). Outcome following traumatic brain injury: A comparison between 2 and 5 years after injury. Brain Injury, 10, 841848.CrossRefGoogle Scholar
Robbins, T.W., James, M., Owen, A.M., Sahakian, B.J., Lawrence, A.D., McInnes, L., & Rabbitt, P.M.A. (1998). A study of performance on tests from the CANTAB battery sensitive to frontal implications for theories of executive functioning and cognitive aging. Journal of the International Neuropsychological Society, 4, 474490.Google Scholar
Schneider, G.E. (1979). Is it really better to have your brain lesion early? A revision of the “Kennard principle.” Neuropsychologia, 17, 557583.CrossRefGoogle Scholar
Statistics Finland. (2003). Finland in figures 2003. Helsinki: University Press.
Stroop, J. (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology, 18, 643662.CrossRefGoogle Scholar
Taylor, H.G., Yeates, K.O., Wade, S.L., Drotar, D., Stancin, T., & Minich, N. (2002). A prospective study of short- and long-term outcomes after traumatic brain injury in children: Behavior and achievement. Neuropsychology, 16, 1527.CrossRefGoogle Scholar
Verger, K., Junque, C., Jurado, M.A., Tresserras, P., Bartumeus, F., Nogues, P., & Poch, J.M. (2000). Age effects on long-term neuropsychological outcome in paediatric traumatic brain injury. Brain Injury, 14, 495503.Google Scholar
Vilkki, J., Ahola, K., Holst, P., Öhman, J., Servo, A., & Heiskanen, O. (1994). Prediction of psychosocial recovery after head injury with cognitive tests and neurobehavioral ratings. Journal of Clinical and Experimental Neuropsychology, 16, 325338.CrossRefGoogle Scholar