The role of social determinants of health in the receipt of school services after traumatic brain injury: A focus review on underserved pediatric populations

Issue title: Pediatric Educational Re-Entry After TBI

Guest editors: Melissa McCart and Susan Davies

Article type: Review Article

Authors: Jimenez, Nathalia^{a; b; *} | Harner, Vern^{c; d} | Oliva, Maria Andrea^b | Lozano, Lorena^b | Fuentes, Molly^{b; e}

Affiliations: [a] Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA | [b] Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, WA, USA | [c] School of Social Work and Criminal Justice, University of Washington-Tacoma, Tacoma, WA, USA | [d] Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, USA | [e] Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA

Correspondence: [*] Address for correspondence: Nathalia Jimenez, MD, MPH, Associate Professor, Anesthesiology, Seattle Children’s Research Institute, University of Washington, 1920 Terry Ave, Seattle, WA 98101, USA. E-mails: nathalia.jimenez@seattlechildrens.org and njimen@uw.edu.

Abstract: BACKGROUND:Return to school is key for community re-integration after a traumatic brain injury (TBI). School support facilitates and ensure a successful transition back to school. However, access to school services is not uniform among U.S. children. OBJECTIVE:To describe school services for children with TBI from minoritized backgrounds and highlight population-specific risk factors and facilitators for accessing services. METHODS:Narrative review of the literature including studies on return to school after a mild-complicated, moderate, or severe TBI, among children enrolled in the U.S. school system. We describe receipt of services, enabling and risk factors, and outcomes, for minority children. RESULTS:There is a gap in knowledge regarding return to school among minoritized children with TBIs. Studies have few participants from racial and ethnic minority backgrounds, or low income or rural communities. Transgender and non-binary youth are not represented in present research efforts. Studies highlight larger barriers to receipt of school services among minority children and additional barriers associated with their minority status. CONCLUSION:Diversity in the U.S pediatric population is increasing. Minoritized populations are at increased risk for TBI and poor outcomes. Research focused on the needs of these populations is required to optimize school return after TBI hospitalization and overall post-discharge care.

Keywords: Traumatic brain injury, children with disability, school based services, medically underserved

DOI: 10.3233/NRE-220210

Journal: NeuroRehabilitation, vol. 52, no. 4, pp. 569-583, 2023