JFK Johnson Rehabilitation Institutes’ Dr. Ashley Kakkanatt coauthored a new study of young people with traumatic brain injury published recently in The Journal of Head Trauma Rehabilitation1 in July of 2022.
The study concluded that social and demographic factors, such as race, substance abuse, and level of functional independence following rehabilitation influence graduation outcomes for young people following TBI. The authors of the study said that these factors require a variety of societal, educational/vocational, and personal interventions to help these students succeed.
Ashley Kakkanatt, M.D., physical medicine and rehabilitation at JFK Johnson Rehabilitation Institute, worked on the study during her fellowship training there. She now serves as an attending physician at JFK Johnson.
About the Study
Individuals from racial and ethnic minority groups not only are at higher risk of TBI2 but also encounter healthcare disparities that magnify the long-term mental, physical and cognitive health effects of TBI, including disparities in services received to support academic and vocational success. 2,3
Of note, one in every 100 Americans aged 15 to 24 visits the emergency department for TBI each year.4 While TBI can have devastating impacts for people of all ages, its effects are especially consequential for adolescents and young adults who are typically pursuing educational goals. The U.S. Department of Education estimates that 27,000 students every year receive services for disability following TBI.5
The study included information from 969 adolescent and young adult students, aged 16 to 24 at their time of injury, which was collected from March 1989 to September 2021. All participants were enrolled in the multicenter Traumatic Brain Injury Model Systems (TBIMS) National Database, which is a study of individuals admitted to inpatient rehabilitation with primarily moderate-to-severe traumatic brain injury. Hackensack Meridian JFK Johnson Rehabilitation Institute* is a TBIMS study site.
The study authors characterized differences between those who did and did not graduate from high school and college within the first five years after their brain injury and identified early predictors of successful high school and college graduation using two different statistical methods.
The study authors defined successful graduation as having a high school diploma or college associate/bachelor's degree at 1-, 2-, or 5-year follow-up. Predictors were sex, race/ethnicity, living in a city, preinjury substance abuse, primary rehabilitation payer, and functional independence at inpatient rehabilitation discharge.
“Of those participants with known graduation status, 81.2% of high school and 41.8% of college students successfully graduated,” said Dr. Kakkanatt. “Graduates in both groups were more often white than Black and had more functional independence at discharge. Among high school students, pre-injury substance abuse was a risk factor for not graduating, as was identifying as Hispanic or ‘other’ race.”
Nearly 25 percent of the high school students and more than 50 percent of the college students in the study did not successfully graduate within five years after their injury. This is a lower successful graduation rate than the national rate for high school students at 86 percent in 2018-2019 and undergraduate college students at 63 percent in 2013.7