Caregiver perceptions of home, school, and community environmental barriers experienced by children with traumatic brain injury
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Date
2022-05
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The Ohio State University
Abstract
Among young people, TBI is a large contributor to mortality and negatively impacts mental and physical health, social skills, and cognitive abilities. A significant proportion of children with TBI report unmet medical and educational needs, and environmental characteristics of the family, school, and surrounding community impact access to supportive services. This research examines caregivers' perspectives to identify environmental barriers experienced by children with TBI and describe the relationship between environmental barriers and demographic/injury characteristics.
Participants (n = 19) were caregivers of children who sustained TBI prior to age 18. Caregivers completed semi-structured phone interviews, which included questions from the Child & Adolescent Scale of Environment (CASE) (Bedell, 2011), a multidimensional scale that addresses physical, attitudinal, and socioemotional problems their child might experience across home, school, and community environments. Participants also provided demographic information and child injury characteristics. Using Spearman's Rank correlations, I identified injury and demographic characteristics that were significantly associated with environmental barriers. Though participants indicated problems in all CASE categories, the most common barriers reported by caregivers included family stress, inadequate school services, and family finances. Greater age at injury and injury severity correlated with fewer barriers to school and community support (p < .05). Caregiver age, education level, and household income were associated with fewer problems in home, school, and medical settings. These results confirm the importance for medical and educational providers to thoroughly follow up with all children who sustain TBI, in addition to assessing caregivers' material and emotional resources. This care is particularly important for younger caregivers and caregivers of lower socioeconomic status, who are more likely to encounter environmental barriers to their child's needs.
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Keywords
pediatric traumatic brain injury, environmental barriers, healthcare disparities, outcomes, family burden, education