An Exploratory Study on Disparities in Service Provision and Long-Term Need After Early Childhood Acquired Brain Injury

Am J Speech Lang Pathol. 2022 Nov 16;31(6):2817-2824. doi: 10.1044/2022_AJSLP-22-00056. Epub 2022 Sep 27.

Abstract

Purpose: While health care and educational disparities are known to impact minoritized groups, few research studies have been conducted to examine disparities after childhood acquired brain injury (ABI). The purpose of this study was to explore child and injury factors (i.e., race, socioeconomic status, and length of hospital stay) associated with referral, parent education, and long-term need for children who experienced an early childhood ABI.

Method: This study was a secondary analysis of data collected through retrospective cohort chart review and prospective caregiver phone surveys.

Results: Exploratory logistic regressions indicated a statistically significant association between child and injury factors and (a) referral to rehabilitation or educational services at hospital discharge (p < .001) and (b) caregiver-reported long-term needs (including both met and unmet needs) for special education services (p = .009). The models for caregiver-reported receipt of education on ABI and caregiver-reported unmet need for special education were not significant. For both significant models, there were no significant individual predictors.

Conclusions: Differences in acute and long-term service provision and need after childhood ABI are likely influenced by a complex interaction of individual, injury, and social-environmental factors. Future research should consider how health care and education practice and policy might account for these interactions to support more equitable access to and utilization of services to improve long-term outcomes for all children with ABI.

Supplemental material: https://doi.org/10.23641/asha.21158878.

MeSH terms

  • Brain Injuries* / rehabilitation
  • Brain Injuries* / therapy
  • Caregivers*
  • Child
  • Child, Preschool
  • Education, Special
  • Health Services Accessibility*
  • Healthcare Disparities*
  • Humans
  • Prospective Studies
  • Retrospective Studies