Neurobehavioral outcomes after early versus late childhood traumatic brain injury.
OBJECTIVE
To examine differences in outcomes at transition age (17-21 years) between individuals who sustained complicated mild-to-severe traumatic brain injury (TBI) in early or middle childhood and those who were injured in late adolescence.


METHODS
Fifteen persons who sustained TBI between the ages of 6 and 12 years (early-onset) and 30 persons who sustained TBI between the ages of 16 and 20 years (late-onset).


METHODS
Peabody Picture Vocabulary Test-Third Edition, Trail-Making Test, Buschke Selective Reminding Test, Benton Visual Retention Test, Dysexecutive Questionnaire, Community Integration Questionnaire, Satisfaction with Life Scale.


RESULTS
The groups did not differ in overall cognitive ability level, postinjury education or vocational accomplishments, or current living situation. However the early-onset group demonstrated worse outcomes in higher-level cognitive skills, social integration, driving, and legal guardianship.


CONCLUSIONS
Complicated mild-to-severe TBI earlier in childhood is associated with worse long-term neurocognitive and psychosocial outcomes than injury sustained in late adolescence. Findings provide further support for theories that early brain injury onset interferes with development of immature or rapidly developing skills, and may be associated with further magnification of deficits during the course of later development.
Donders
Jacobus
J
Psychology Service, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI 49503, USA. jacobus.donders@maryfreebed.com
Warschausky
Seth
S
D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001334:Automobile Driving; D001930:Brain Injuries / Q000534:rehabilitation*; D002648:Child; D004651:Employment; D006801:Humans; D015601:Injury Severity Score; D009483:Neuropsychological Tests; D012917:Social Adjustment