Objective: To investigate presence of and factors associated with self-and parent-reported Fatigue seven years after severe childhood traumatic brain injury (TBI) in the prospective longitudinal study TGE (Traumatisme Grave de l'Enfant -severe childhood trauma). Method: Self-and/or parent-reports on the Multidimensional Fatigue Scale (MFS) were collected for 38 participants (ages 7-22 years) seven years after severe childhood TBI, and 33 controls matched for age, gender and parental educational level. The data collected included socio-demographic characteristics, age at injury and injury severity scores, overall disability (Glasgow Outcome Scale Extended, GOS-E), intellectual outcome (Wechsler scales) and questionnaires assessing executive functions, Health-Related Quality of Life (HRQoL), behavior and participation.Results: Fatigue levels were significantly worse in the TBI than in the control group, especially for cognitive fatigue. Correlations of reported fatigue with age at injury, gender, TBI severity and intellectual ability were moderate and often not significant. Fatigue was significantly associated with overall level of disability (GOS-E), and with all questionnaires completed by the same informant. Conclusion:High levels of fatigue were reported by 30 to 50% of patients seven years after a severe childhood TBI. Reported fatigue explained more than 60% of the variance of reported HRQoL by the same informant (patient or parent).

The aims of this study were (1) to prospectively measure memory functioning following severe childhood Traumatic Brain Injury (TBI), and its evolution over 2 years; (2) to assess demographic and medical factors associated with memory function and recovery; (3) to explore relations between memory and other TBI outcomes.Methods: Children (aged 0-15 years; n=65) consecutively admitted in a single trauma centre over a 3-year period, who survived severe non-inflicted TBI, were included in a prospective longitudinal study. Memory was assessed in 38 children aged 5-15 years at injury, using the Children's Memory Scale at 3, 12, and 24-months post-injury.Results: Mean general memory score was low at 3 months (M=90.2, SD=20.3) but within the normal range at 12 and 24 months (M=100.6, SD=23.1 and M=108.6, SD=24.1, respectively), with high variability. Improvement was stronger for immediate visual memory than for other memory indices. Lower general memory score was associated with higher injury severity, lower intellectual ability and functional status, higher overall disability, and ongoing education. Conclusion:Memory functioning is highly variable following severe childhood TBI, related to injury severity and functional, cognitive and educational outcomes; improvement is significant during the first-year post-injury, but varies according to the type of memory.

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Purpose: Participation in home, school and community activities is considered as the ultimate aim of rehabilitation. The aims of this study were to examine participation seven years post-severe childhood traumatic brain injury and factors associated with participation. Materials and methods: Participants were enrolled in the Traumatisme Grave de l'Enfant (Severe Childhood Injury) cohort study following severe accidental childhood traumatic brain injury. Participation seven years post-injury, was examined using parent-and self-report forms of the Child and Adolescent Scale of Participation among 37 patients [62% males, mean age 15.4 years (SD=4.4), mean length of coma 6.68 days (SD=4.96)] and 33 matched controls.Results: Parent reports indicated significantly lower participation among patients compared to controls, but the self-reports did not. In the traumatic brain injury group, parent-reported participation was variable, with 22% of the patients clearly showing greater restrictions than controls. Participation restrictions were significantly associated with injury severity, poor functional outcome one-year post-injury, executive and behavioral difficulties and higher fatigue levels seven years post-injury, but not with pre-injury nor family factors.Conclusions: Several years after severe childhood traumatic brain injury, participation appears to depend more on injury-related factors than on environmental factors. In selfreports assessments of participation, it could be difficult for children and adolescents to distinguish capacity from performance.