Category: Brain Injury; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Health Services Research
Objective : To establish whether women in shelter programs in Nebraska, who screen positive for a possible brain injury (BI), have higher rates of learning disorder (LD) as compared to the general population.
Design : Staff members at 2 regional domestic violence programs in Nebraska underwent training regarding BI, and how to use a modified HELP Brain Injury Screening Tool. Persons who tested positive on the HELP screening tool were offered follow-up neuropsychological evaluation.
Two regional Domestic violence programs in the state of Nebraska.
Participants (or Animals, Specimens, Cadavers) : Participants included 32 women who sought services during a 12-month period in 2016.
Interventions : Interventions: Not applicable.
Main Outcome Measure(s) : Incidents of hits/strangulations and losses of consciousness, as measured by the modified HELP questionnaire, as well as prior history of LD are described in this study.
Results : 13 of the 32 survivors (40.6%) screened as positive for a history of learning disability as assessed by having received special education services while attending school. This figure is opposed to the approximately 10% of persons in the general population that are diagnosed with LD. 61.5% of survivors with a history of LD reported being assaulted until they were unconscious (LOC), as opposed to 44% of persons without a history of LD. Survivors with LD also endorsed having more cognitive and emotional difficulty after assault, based on their higher overall scores on the Rivermead Post-Concussion Symptoms Questionnaire. Survivors with LD scored an average of 49.8 vs an average score of 39.28 for survivors without LD. The groups did not differ on other violence-related variables including number of times assaulted or episodes of assault related hypoxia.
Conclusions : We conclude that women seeking shelter services in Nebraska have a higher percentage of learning disorders as compared to the general population. Further, survivors in this research study with a history of LD experienced more frequent violence-related LOC, and possibly greater levels of physical violence given their ratings of symptoms after the assault. Much more research on the intersection between learning disorder and domestic violence is required to discover how the presence of LD may confer risk for domestic violence.
Kate Higgins– Clinical Neuropsychologist, Sanford Health Systems, Omaha, Nebraska
Kathy Chiou– Assistant Professor, University of Nebraska-Lincoln, Lincoln, Nebraska
Matthew Garlinghouse– Neuropsychologist, University of Nebraska Medical Center, Omaha, Nebraska
Peggy Reisher– Executive Director, Brain Injury Alliance of Nebraska, Lincoln, Nebraska