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

Author:

Anderson Vicki123,Godfrey Celia1,Rosenfeld Jeffrey V.45,Catroppa Cathy123

Affiliation:

1. Department of Child Neuropsychology, Murdoch Childrens Research Institute, Melbourne, Australia;

2. Department of Psychology, Royal Children’s Hospital, Melbourne, Australia;

3. Department of Psychological Sciences University of Melbourne, Melbourne, Australia;

4. Department of Medicine, Monash University, Melbourne, Australia; and

5. Neurosurgery Department, The Alfred Hospital, Melbourne, Australia

Abstract

BACKGROUND AND OBJECTIVES: Childhood traumatic brain injury (TBI) has implications for functional outcomes, but few studies have documented long-term outcomes. The purpose of this study was to plot recovery of cognitive and functional skills after early childhood TBI to 10 years postinjury and to identify the contribution of injury, environment, preinjury characteristics, and acute functional recovery. METHODS: Subjects were recruited consecutively to this prospective, longitudinal study, which used a between-factor design, with injury severity as the independent variable. Forty children with TBI aged 2 and 7 years were recruited on admission to a tertiary pediatric hospital, divided according to injury severity, and compared with 16 healthy controls acutely and 12 and 30 months and 10 years postinjury. Cognition, adaptive ability, executive function, and social/behavioral skills were examined. RESULTS: Children with severe TBI had poorest outcomes, with deficits greatest for cognition. Recovery trajectories were similar across severity groups but with significant gains in verbal skills from 12 and 30 months to 12 months and 10 years. Predictors of outcome included preinjury ability (for adaptive function) and family function (social/behavioral skills). CONCLUSIONS: Results confirm a high risk of persisting deficits after severe TBI in early childhood. Children with less severe TBI appear to recover to function normally. Contrary to speculation about “growing into deficits,” after protracted recovery to 30 months, young children make age-appropriate progress at least to 10 years postinsult. Environmental factors were found to contribute to adaptive and social/behavioral recovery.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology, and Child Health

Reference37 articles.

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2. Intellectual outcome from preschool traumatic brain injury: a 5-year prospective, longitudinal study;Anderson;Pediatrics,2009

3. Severity of pediatric traumatic brain injury and neurobehavioral recovery at one year—a cohort study;Jaffe;Arch Phys Med Rehabil,1993

4. Influence of age-related factors on long-term outcome after traumatic brain injury (TBI) in children: a review of recent literature and some preliminary findings;Benz;Restor Neurol Neurosci,1999

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