The effects of head injury in children on neuropsychological and behavioural functioning

Abstract

In a prospective study 76 children were divided into three groups on the basis of severity of head injury as defined by the Glasgow Coma Scale and duration of increased intracranial pressure. The children were administered a neuropsychological test battery and behavioural ratings were made by parents and teachers at three intervals: time of hospital discharge and 3 and 9 months post-initial testing. There were cognitive deficits related to severity of injury with the greatest difference in abilities observed between the severe and the other two groups. The greatest differences in skills were on the Performance IQ and timed tests of visual-motor speed and co-ordination. The greatest improvement in skills occurred in the first 3 months post-injury. Several children in coma for up to 4 weeks were able to obtain normal IQ scores. In the mild and moderate injury groups very few had behavioural change while in the severe group approximately 90% had one learning or adjustment difficulty and 40% had three or more problems.

The Development of a Trial Making Test in Young Children: The TRAILS-P

“…For example, O'Leary et al (1983) found that school-aged children and adolescents with early onset epileptic seizures (before age 5) performed more poorly on both Parts A and B compared to those children with late onset seizures. Knights et al (1991) reported that children with severe traumatic brain injuries took more time to complete Parts A and B of the TMT than children with mild and moderate head injuries. However, Ewing-Cobbs et al (1998) found that TMT performance differences were due to age, but not due to the severity of the injury, in a sample of 91 children who had incurred traumatic brain injuries.…”

Parent-Child Interaction Therapy as a Family-Focused Approach for Young Children with Traumatic Brain Injury

“…These rates of clinically significant change were somewhat lower than anticipated, but may be attributable to the use of a lower cutoff score. This finding also is consistent with literature that suggests low sensitivity to the behavioral sequelae of pediatric TBI (Kinsella et al, 1995;Knights et al, 1991). In fact, two studies found that structured interviews identified more post-TBI behavior problems than parent ratings (Bloom et al, 2001;Green, Foster, Morris, Muir, & Morris, 1998).…”

Comparison of Cognitive Performances During a Placebo Period and an Atypical Antipsychotic Treatment Period in Schizophrenia: Critical Examination of Confounds

“…Clearly, global insults in brain function impair one's ability to perform in many domains of cognitive testing, and this manner of impairment can be reversed with clinical improvement in general brain function (Knights et al, 1991;Mandleberg and Brooks, 1975;Mayes et al, 1989;White et al, 1986). This raises the question of whether the improvements we observed represent a true cognitive enhancement per se or simply restoration of more effective utilization of cognitive resources that pre-existed the symptomatic state of psychosis and that were unavailable or dysfunctional during the more clinically disturbed state.…”