Cognitive predictors of academic achievement in young children 1 year after traumatic brain injury.

OBJECTIVE: To examine cognitive predictors of academic achievement in young children with traumatic brain injury (TBI) and orthopedic injury (OI) shortly after injury and 1 year postinjury.

METHODS: Participants included 3- to 6-year-old children, 63 with TBI (46 with moderate TBI and 17 with severe TBI) and a comparison group of 80 children with OI. Academic achievement was assessed approximately 1 and 12 months postinjury using three subtests from the Woodcock-Johnson Tests of Achievement-Third Edition and the School Readiness Composite from the Bracken Basic Concepts Scale-Revised. General intellectual functioning, memory, and executive functions were measured at the initial assessment using standardized tests.

RESULTS: Hierarchical linear regression was used to predict academic achievement at the initial and 1-year follow-up assessments. Memory and executive functions were significant predictors of academic achievement at both assessments after controlling for group membership and demographic variables. Executive function remained a significant predictor of some outcomes after taking general intellectual functioning into account. Predictive relationships did not vary across the TBI and OI groups. Similar results were obtained when regression analyses were completed with only TBI participants using the Glasgow Coma Scale score as a predictor, although memory and executive functioning were somewhat less robust in predicting academic achievement than before.

CONCLUSION: Memory and executive function predict academic achievement after TBI in preschool children, although some of the associations may be accounted for by general intellectual functioning.