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OSU TBI-ID

Other Sources of Central Nervous System Compromise


The validation studies of the OSU TBI-ID, as well as studies since, have found that a history of TBI in conjunction with another source of damage to the brain (i.e., central nervous system [CNS] compromise) can make the overall impact on current function worse than if either one or the other were present. These studies found that the most important other sources were those associated with psychiatric and substance use disorder histories, as well as indication of a childhood developmental problem. Having a history of TBI along with one of these other sources of brain damage was worse than either one alone.

The form linked here is abbreviated from the longer form used in the initial validation study (Corrigan & Bogner, 2007). It does not include psychiatric or substance abuse history as the contribution of these potential other sources of CNS compromise required an indication of more than a simple yes/no.

Abbreviated Other CNS Compromise Form

More findings on lifetime history of TBI and other sources of CNS compromise

Corrigan & Bogner (2007) examined the contribution of other sources of CNS compromise by taking a medical history to identify risk factors for developmental delays and medical conditions that could result in CNS compromise during childhood or as an adult. Three measures were created by summing the number of component conditions: risk of developmental delay  (premature birth, late birth, birth complications, walking or talking late, other developmental delays, muscle weakness, hearing impairments, speech problems, visual impairments, frequent ear infections, attention problems, hyperactivity, learning disability); childhood CNS compromise  (seizure disorder, meningitis, anoxia, exposure to lead paint); and adult CNS compromise (AIDS, brain tumor, Huntington’s disease, meningitis, multiple sclerosis, psychosis, dementia, stroke, anoxia, seizure disorder). 

In this initial validation study 13% reported complications at birth; 43% reported attention problems during their childhood, most with concomitant hyperactivity; 27% indicated they had a learning disability; and 18% reported having speech impairments. Twenty-four percent noted exposure to lead paint in their childhood homes. Diseases affecting the central nervous system were less frequent, with 4 subjects reporting childhood seizure disorders, 14 adult seizure disorders, 2 having meningitis in childhood, 3 with adult onset brain tumors, 6 with adult onset stroke, and 4 with anoxia experienced as an adult.

Developmental delay and/or childhood CNS entered into most of the predictive models in this initial validation of the OSU TBI-ID. There were very strong bivariate relationships between developmental delay and childhood CNS for weighted severity (a combination of number of injuries and their severity), as well as younger age at first injury. Studies since have also found that children with other sources of compromise are both more likely to incur a TBI and to have greater consequences after.

Bogner & Corrigan, (2009) focused specifically on psychiatric, substance use disorder and childhood developmental disability. For the latter, a questionnaire inquired about a history of learning disability (using items from the Colorado Traumatic Brain Injury Registry and Follow-up System and participation in special education classes (from the TBI Model Systems National Dataset). For learning disability, 26% of males and 8% of females reported a positive history. Sixteen percent of males and 9% of females reported being in special education classes.

Being in special education classes remained a predictor in logistic regressions for a wide variety of cognitive performance, behavioral control and emotional functioning variables. Learning disability remained a predictor for self-reported cognitive problems, only. Psychiatric and substance use disorder indices predicted behavioral control and emotional functioning variables.

References

Bogner, J.A., Corrigan, J.D. (2009). Reliability and validity of the OSU TBI Identification Method with Prisoners.  Journal of Head Trauma Rehabilitation, 24(6), 279-291.

Corrigan, J.D., Bogner, J.A.  (2007). Initial reliability and validity of the OSU TBI Identification Method. Journal of Head Trauma Rehabilitation, 22(6), 318-329.

This website has been funded with financial assistance from Grant #H133A120086 awarded by the U.S. Department of Education, National Institute on Disability Rehabilitation Research (NIDRR) to the Ohio Valley Center for Brain Injury Prevention and Rehabilitation for the current funding period of 10/01/2012 - 09/30/2017.