WRITTEN LANGUAGE PRODUCTION AND NEUROPSYCHOLOGICAL FUNCTION IN CHILDREN WITH TRAUMATIC BRAIN INJURY

Objective: To establish the early consequences of traumatic brain inju ry (TBI) on spontaneous written language production in children by exa mining writing deficits as a function of injury severity and con-elati ng written performance with neuropsychological data. Design: Case-cont rol cohort study. Setting: Two regional medical centers. Patients: Sev enty-six children, aged 8 to 15 years, with mild, moderate, or severe closed head injury were compared with controls who were individually m atched on the premorbid characteristics of age, gender, school grade, behavior, and academic performance. Main Outcome Measures: Assessment of written language production and neuropsychological function was und ertaken approximately I month following resolution of posttraumatic am nesia. Case-control differences on 16 measures of spontaneous written narratives were computed. Results: Factor analysis and conceptual simi larities suggested that the measures of written language fell into fiv e domains: Efficiency, Completeness, General Readability, Error, and V ocabulary. A highly significant, moderate correlation between these me asures and severity of injury was found. The highest correlations were found for the written language domains of Efficiency and Completeness and the lowest for the Vocabulary domain. Moderate correlations were also found between measures of written language and neuropsychological function. Conclusions: At 1 month after resolution of posttraumatic a mnesia, written language production in children with TBI is negatively correlated with severity of injury. Some aspects of written language production are affected to a greater extent than others. Considerable common around was found between written language production and neurop sychological function. (C) 1997 by the American Congress of Rehabilita tion Medicine.