Citation

Aguilar JM, Cassedy AE, Shultz EL, Kirkwood MW, Stancin T, Yeates KO, Taylor HG, Wade SL. J. Head Trauma Rehabil. 2019; 34(2): 65-76.

Affiliation

Division of Physical Medicine and Rehabilitation (Drs Aguilar and Wade and Ms Shultz) and Division of Biostatistics and Epidemiology (Dr Cassedy), Cincinnati Children's Hospital Medical Center, Ohio; University of Cincinnati, Ohio (Ms Shultz and Dr Wade); Children's Hospital Colorado, Denver (Dr Kirkwood); Metrohealth Medical Center, Cleveland, Ohio (Dr Stancin); Case Western Reserve University, Cleveland, Ohio (Drs Stancin and Taylor); Department of Pediatrics and Clinical Neurosciences, University of Calgary, Ontario (Dr Yeates); and Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Cleveland, Ohio (Dr Taylor).

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000443

PMID

30499926

Abstract

OBJECTIVE: To examine the effectiveness of a web-based parenting intervention (Internet-Based Interacting Together Everyday: Recovery After Childhood TBI [I-InTERACT]) and an abbreviated version (Express) in reducing executive dysfunction and internalizing problems among young children following traumatic brain injury (TBI).

METHOD: Parents of 113 children (ages 3-9 years) who had sustained a TBI were randomized to 1 of 3 treatment groups: I-InTERACT, Express, or an Internet Resource Comparison (IRC) group. Parents who participated in either I-InTERACT or Express completed self-guided web sessions and received live coaching of their parenting skills via videoconferencing with a therapist. I-InTERACT included additional psychoeducation, stress management, and family communication skills (eg, marriage, grief, pain, and sleep). Analyses of covariance were utilized to compare the groups on parent-reported executive function behaviors (ie, Behavior Rating Inventory of Executive Function) and internalizing symptoms (ie, Child Behavior Checklist) at baseline and 6 months.

RESULTS: Parents who participated in Express reported significantly lower levels of executive dysfunction than those in I-InTERACT, β = -0.49; t(2, 73) = -2.47, P =.048, and significantly lower levels of withdrawal than those in the IRC group, β = -0.44; t(2, 74) = -2.22, P =.03. The Express group did not significantly differ from the IRC group on executive function behaviors or the I-InTERACT group on internalizing problems, all P >.05. Children with more problems at baseline, families with lower education levels, and parents with more symptoms of depression benefited most.

CONCLUSION: A brief, online parent training intervention may be efficacious in improving executive dysfunction and internalizing problems following early TBI, particularly among children of lower socioeconomic status or with existing behavioral concerns.

Language: en