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

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Study evaluated the utility of the School Transition and Re-entry Program (STEP) model, a systematic hospital-to-school transition protocol for children hospitalized for traumatic brain injury (TBI). One hundred families of children with mild, complicated mild, moderate, or severe TBI were randomized while hospitalized to receive STEP or usual care. The study’s primary outcomes were identification for special education services and increased receipt of accommodations and modifications. Parents completed a questionnaire documenting their child’s hospital-to-school transition and the supports provided by the school at one month post discharge and approximately one year later. At these assessments, parents also completed surveys about their child’s behavior and their participation in school and community. Parent satisfaction with their child’s school program was assessed at one-year follow-up. There were no significant effects, indicating that STEP participants did not differ from usual care participants on any study outcome at one month after discharge or at one-year follow-up. 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 program delivery.

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