Results from a randomized trial evaluating a hospital–school transition support model for students hospitalized with traumatic brain injury

OBJECTIVE: To evaluate the utility of the STEP model, a systematic hospital-school transition protocol for children hospitalized for TBI. SETTING: Five children's hospitals in Colorado, Ohio, and Oregon. PARTICIPANTS: Hundred families of children with mild, complicated mild, moderate, or severe TBI. DESIGN: Randomized controlled trial (RCT); participants were randomized while hospitalized to the STEP (a standardized hospital-school transition protocol for children treated for TBI) or usual care condition. MAIN MEASURES: Questionnaire about child's special education eligibility status, support services, and academic accommodations; Achenbach Child Behaviour Checklist (CBCL); Behaviour Rating Inventory of Executive Function (BRIEF); Child and Adolescent Scale of Participation (CASP); Child and Adolescent Scales of Environment (CASE) Results: There were no significant effects, indicating that STEP participants did not differ from usual care participants on any study outcome at one month post-discharge or at one-year follow-up. CONCLUSION: The lack of significant findings in this study does not imply that effective hospital-to-school transition programming is unnecessary. Rather, the findings raise important questions regarding timing and dosage/intensity of intervention, appropriate measurement of outcomes, and fidelity of programme delivery. The study highlights difficulties involved in the conduct of community-based RCTs in the paediatric TBI population.