Parents and primary care physicians should consider that children with traumatic brain injury (TBI) may need ongoing support to address difficulties with memory, problem solving, and verbal communication when transitioning from inpatient rehabilitation to home and school, according to a study conducted by researchers at The Children’s Hospital of Philadelphia.

The retrospective cohort study published in the Journal of Pediatrics included data from nearly 14,000 children ages 7 to 18 years with trauma-related injuries who completed inpatient rehabilitation during the period from 2002 to 2011.

Researchers analyzed the children’s cognitive deficits before and after admission to inpatient rehabilitation. Children with TBI had more cognitive disability when entering inpatient rehab than other children with serious injuries, which included spinal cord injury, multiple fractures, amputations, and burns. While all injury groups showed improvements upon discharge, children with TBI had more residual cognitive disability.

“These children may continue to improve after discharge, so this transition is a critical point in their care,” said the study’s leader, Mark Zonfrillo, MD, MSCE, an investigator at CHOP’s Center for Injury Research and Prevention (CIRP) and associate director of research in the division of emergency medicine.

It is important for primary care providers, rehabilitation staff, and parents to communicate with each other during this transition period, Dr. Zonfrillo added. They also can contact local associations and organizations that offer resources for individuals living with brain injuries.

“The goal of this line of research at CHOP is to maximize access to trauma systems and to optimize acute and rehabilitation care for young patients with serious injuries,” Dr. Zonfrillo said. “If we have a complete picture of the scale of pediatric traumatic injuries and related long-term needs, as well as the differences between injury patterns and various outcomes, we can predict the type and level of support necessary upon discharge from inpatient rehabilitation.”

CIRP’s Dennis Durbin, MD, MSCE, and Flaura K. Winston, MD, PhD, also contributed to the investigation.