Understanding predictors of functional recovery and outcome 30 months following early childhood head injury.

Abstract

Much is known about outcome following traumatic brain injury (TBI) in school-age children; however, recovery in early childhood is less well understood. Some argue that such injuries should lead to good outcome, because of the plasticity of the developing brain. Other purport that the young brain is vulnerable, with injury likely to result in a substantial impairment (H. G. Taylor & J. Alden, 1997). The aim of this study was to examine outcomes following TBI during early childhood, to plot recovery over the 30 months postinjury, and to identify predictors of outcome. The study compared 3 groups of children sustaining mild, moderate, and severe TBI, ages 2.0 to 6.11 years at injury, with healthy controls. Groups were comparable for preinjury adaptive and behavioral function, psychosocial characteristics, age, and gender. Results suggested a strong association between injury severity and outcomes across all domains. Further, 30-month outcome was predicted by injury severity, family factors, and preinjury levels of child function. In conclusion, children with more severe injuries and lower preinjury adaptive abilities, and whose families are coping poorly, are at greatest risk of long-term impairment in day-to-day skills, even several years postinjury.

Long-term neural processing of attention following early childhood traumatic brain injury: fMRI and neurobehavioral outcomes

“…Pediatric traumatic brain injury (TBI) results in substantial neurobehavioral morbidity for survivors, including persistent impairments in emotional, social, behavioral, and neuropsychological functioning that persist well beyond the acute phase of injury (e.g., Anderson et al, 2001Anderson et al, , 2006Taylor et al, 2002;Yeates et al, 2005). A clear relationship has been observed for physical and cognitive outcomes in TBI, with the severity of TBI contributing to greater impairment .…”

Late Proton Magnetic Resonance Spectroscopy following Traumatic Brain Injury during Early Childhood: Relationship with Neurobehavioral Outcomes

“…Although research involving young children with TBI is scant, several researchers have demonstrated that children injured at a younger age have worse neurobehavioral outcomes than children injured when they are older (Anderson et al, 2005). Because many neurobehavioral skills are emerging rapidly during early childhood, young children may be particularly susceptible to long-term disruption of neurobehavioral development (Anderson et al, 2005(Anderson et al, , 2006. Because of high incidence, morbidity, and survival, TBI in early childhood is a serious health concern that affects a large number of children, families, and communities.…”

Predictors of Cognitive Function and Recovery 10 Years After Traumatic Brain Injury in Young Children

“…7,8 Few studies, however, have prospectively followed survivors of early TBI into adolescence, and those available focus primarily on cognition. In addition, several factors have been identified that contribute to deficits after school-aged TBI (injury severity and age, premorbid child and family function), [9][10][11][12][13] but it is unclear whether these factors also explain outcomes for younger children.…”