title: Late intellectual and academic outcomes following traumatic brain injury sustained during early childhood.
abstract: OBJECTIVE
  Although long-term neurological outcomes after traumatic brain injury (TBI) sustained early in life are generally unfavorable, the effect of TBI on the development of academic competencies is unknown. The present study characterizes intelligence quotient (IQ) and academic outcomes an average of 5.7 years after injury in children who sustained moderate to severe TBI prior to 6 years of age.
  
  
  METHODS
  Twenty-three children who suffered inflicted or noninflicted TBI between the ages of 4 and 71 months were enrolled in a prospective, longitudinal cohort study. Their mean age at injury was 21 months; their mean age at assessment was 89 months. The authors used general linear modeling approaches to compare IQ and standardized academic achievement test scores from the TBI group and a community comparison group (21 children). Children who sustained early TBI scored significantly lower than children in the comparison group on intelligence tests and in the reading, mathematical, and language domains of achievement tests. Forty-eight percent of the TBI group had IQs below the 10th percentile. During the approximately 5-year follow-up period, longitudinal IQ testing revealed continuing deficits and no recovery of function. Both IQ and academic achievement test scores were significantly related to the number of intracranial lesions and the lowest postresuscitation Glasgow Coma Scale score but not to age at the time of injury. Nearly 50% of the TBI group failed a school grade and/or required placement in self-contained special education classrooms; the odds of unfavorable academic performance were 18 times higher for the TBI group than the comparison group.
  
  
  CONCLUSIONS
  Traumatic brain injury sustained early in life has significant and persistent consequences for the development of intellectual and academic functions and deleterious effects on academic performance.
authors.affiliation: Department of Pediatrics, University of Texas Health Science Center at Houston, 70030, USA. linda.ewing-cobbs@uth.tmc.edu
authors.forename: Linda
authors.initials: L
authors.lastname: Ewing-Cobbs
authors.forename: Mary R
authors.initials: MR
authors.lastname: Prasad
authors.forename: Larry
authors.initials: L
authors.lastname: Kramer
authors.forename: Charles S
authors.initials: CS
authors.lastname: Cox
authors.forename: James
authors.initials: J
authors.lastname: Baumgartner
authors.forename: Stephen
authors.initials: S
authors.lastname: Fletcher
authors.forename: Donna
authors.initials: D
authors.lastname: Mendez
authors.forename: Marcia
authors.initials: M
authors.lastname: Barnes
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Zhang
authors.forename: Paul
authors.initials: P
authors.lastname: Swank
mesh_terms: D001930:Brain Injuries / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004519:Education, Special; D004522:Educational Status; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007360:Intelligence; D007807:Language Tests; D008137:Longitudinal Studies; D008297:Male; D008433:Mathematics; D011446:Prospective Studies; D011932:Reading; D012151:Resuscitation