Independent Living and Social Participation at 2- and 5-Year Follow-up of Late Adolescents with TBI

Research Objectives: To describe independent living and participation outcomes at 2- and 5-years post-injury for adolescents who sustained TBI requiring inpatient rehabilitation

Design: Secondary data analysis of a multi-center database of individuals with complicated mild to severe TBI who received rehabilitation

Setting: Community

Participants: Cross-sectional sample of 478 adolescents (age 16-18), in high school at time of injury, followed at year 2 (n=366) and year 5 (n=311)

Interventions: N/A

Main Outcome Measures: Independent Living versus living with parent or adult family; Employment/productivity; Participation with Recombined Tools- Objective (PART-O)

Results: Less than 1/4 of the sample were living independently, as defined by living alone, with peers, or spouse/significant other, at year 2 and year 5, with no difference between years. The percentage living independently at 2 years was a significant increase relative to discharge (1% to 21%; p <.01).

Percentage of the sample competitively employed or engaged in academic pursuit was 97.5% prior to injury, but was 60.4% at year 2 and 57.4% at year 5.

PART-O scores tended to trend on the lower end of the T-score range for Productivity and Out and About, but within the middle range for Social Integration, with no overall score differences across time points (2- and 5-year follow-ups).

Individual item analysis of PART-O relationship items showed no significant difference between 2- and 5-years. At both time points, less than half the sample were involved in an intimate, romantic or sexual relationship, and fewer than one-fourth were living with a spouse/significant other. Over 78% of the sample had a best friend to confide in at both times.

Conclusions: TBI sustained during late adolescence can lead to difficulty transitioning to independent living, productive activity, and intimate relationships over 2 to 5 years post-injury. Our sample ranged from age 17-21 at year 2 and age 20-24 at year 5. Lack of transition to independent living and productive activity indicates the need for targeted interventions to aid with transition to adulthood.

Author(s) Disclosures: This work was a collaboration of TBI Model Systems supported by NIDILRR funding.