Effectiveness of a head injury program for children: a preliminary investigation.

Abstract

The purpose of this study was to investigate whether a more coordinated, comprehensive head injury rehabilitation program provided at a children's trauma center yielded better outcomes than a less coordinated, less comprehensive program. Using a quasi-experimental design, 64 children with head injury admitted to the center and who received rehabilitation services in either 1995 or 1993 were evaluated by using the Functional Independence Measure for children (WeeFIM)/The Functional Independence Measure (FIM) (e.g., primary outcome measure). Secondary outcomes included "psychosocial adjustment," "return to regular school," and "current problems related to the head injury." No statistically significant differences were found between the groups with respect to mean WeeFIM/FIM scores after controlling for age and injury severity. The 1993 group had poorer scores on the withdrawal subscale of the psychosocial measure (P = 0.02), yet a smaller proportion of these children were enrolled in a special education class (P = 0.02). This study serves as a model for a larger, definitive study of the effectiveness of rehabilitation for children with head injury. The trends suggest that more comprehensive care may lead to better outcomes.