PRIMARY OBJECTIVES: To explore the relative effectiveness of clinician-delivered versus family-supported interventions for children with chronic impairment after TBI. RESEARCH DESIGN: Randomized controlled clinical trial. METHODS AND PROCEDURES: Children aged 5 to 12 years in the chronic phase of their recovery were randomly assigned to the clinician-delivered or to the family-supported intervention group; both samples received intensive services for 1 year; physical outcome was measured by the SARAH scales, cognitive outcome by the WISC-III. MAIN OUTCOMES AND RESULTS: Parents in the family-supported intervention sample efficiently acquired the skills needed to deliver physical and cognitive interventions within the context of everyday routines of the child's life at home; family education level was not a factor. Although both groups demonstrated improvements, only the children in the family-supported intervention group demonstrated statistically significant -- and clinically important -- improvements on both outcome measures. CONCLUSIONS: This RCT provides compelling evidence for organizing cognitive and physical interventions and supports for children with TBI around the everyday routines of their lives, with intensive supports for their families.

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