Predicting recovery from head injury in young children: A prospective analysis

Abstract

It has been argued that young children's brains are “plastic,” and may sustain substantial brain insult with little loss of function. Recent research suggests that this notion may not apply for generalized cerebral pathology. The present study aimed to evaluate this proposition using a sample of 73 young children, divided into 3 groups: severe head injury (HI; N = 17); mild–moderate HI (N = 32); and noninjured controls (N = 24). Preinjury screening established equivalence across groups for age, sex, preinjury ability, behavioral adjustment, socioeconomic status, and family functioning. Children were evaluated as soon as possible postinjury, and again 12 months postinjury, in three domains: intellectual ability, language, and memory. Results indicated that severe HI was associated with substantial, persisting difficulties in all areas. In contrast, children with mild–moderate HI experienced fewer difficulties, and often performed similarly to controls, both acutely and 12 months postinjury. There was no evidence of differential recovery of function associated with injury severity, with performance increments consistent across groups and probably due to either age-appropriate developmental gains, or test–related practice effects. Poorer outcome at 12 months postinjury was predicted by injury severity primarily, with earlier age at injury, and premorbid ability associated with outcome in specific domains. (JINS, 1997, 3, 568–580.)

Cognitive dysfunction in young men following head injury in childhood and adolescence: a population study

“…[8][9][10] Our present evidence also supports other findings indicating that the long term prognosis for cognitive functioning may not be better for children injured at an early age than later. [5][6][7] To the extent that psychosocial risk contributes to a greater degree with increasing age for severe cerebral lesions as well, our findings may be masking a more marked neurological effect of earlier injuries as compared with later ones.…”

“…1 There remains, however, uncertainty over possible differential effects of age at injury, and earlier perceptions that recovery is better at young ages 2-4 are now questioned. [5][6][7] There have also hitherto been comparatively few studies that have examined the continuing consequences of pre-adult head injury on cognitive functioning in adulthood, and here too results have been conflicting. [8][9][10] With regard to mild head injury, most evidence points to substantial recovery of cognitive functioning within at most weeks, regardless of age, 11 although again some studies have suggested enduring consequences.…”

Identifying factors contributing to child and family outcome 30 months after traumatic brain injury in children

“…7 8 Developmental issues, including age and development stage, have been found to interact with injury related parameters and impact on outcome. [9][10][11][12][13][14] The importance of preinjury cognitive and behavioural status, family functioning, and quality of the environment is less clear. 15 16 Persisting disabilities after TBI place stress on both the family and the child, and require ongoing rehabilitation, additional educational resources, and family advocacy.…”

Cognitive reserve in paediatric traumatic brain injury: Relationship with neuropsychological outcome

“…Hence, developmental factors may exert a significant influence on cognitive functioning after TBI by rendering the child less capable of responding to the challenge of TBI. This implication is supported by a number of studies demonstrating that early age at insult is associated with more detrimental and persisting effects in a number of cognitive domains [28][29][30]. In particular, previous research has documented clear evidence that childhood TBI represents a risk factor for difficulties in acquiring basic word decoding skills [17].…”