Language and cognition in a bilingual child after traumatic brain injury in infancy: long-term plasticity and vulnerability.
OBJECTIVE
This study aimed at investigating the long-term effects of the combination of severity of injury and time of injury in a 6-year-old bilingual Arabic-Italian child who sustained a severe left traumatic brain injury at the age of 7 months.


METHODS
Standard neurological, cognitive and neuropsychological assessments were administered at 40 days after surgery and again at 18, 31, 62 and 73 months.


RESULTS
The child presented with developmental arrest at 18 and 31 months. Later on, right hemiparetic and oculomotor signs gradually improved to a significant extent, as well as dysexecutive, visuospatial and praxic deficits. At present, persistent language disorders in a fluent speech characterize the child's profile to a similar extent and type in both languages, suggesting common underlying learning strategies which are ineffective for procedurally acquiring language.


CONCLUSIONS
This case confirms that children who sustain severe left hemisphere traumatic brain injury in infancy present with increased vulnerability to linguistic deficits. Left frontotemporal, cortical-subcortical lesions which occur during very early language development may permanently disrupt the procedural language acquisition network required for first language acquisition.
Tavano
Alessandro
A
Neurolinguistics Unit, Scientific Institute E. Medea, Via Cialdini 29, Pasian di Prato (UD), Italy. alessandro.tavano@pp.Lnf.it
Galbiati
Susanna
S
Recla
Monica
M
Formica
Francesca
F
Giordano
Flavio
F
Genitori
Lorenzo
L
Strazzer
Sandra
S
D001037:Aphasia / Q000503:physiopathology* / Q000534:rehabilitation; D001930:Brain Injuries / Q000503:physiopathology* / Q000534:rehabilitation; D002648:Child; D002657:Child Development; D006801:Humans; D007802:Language; D008037:Linguistics; D008297:Male; D019303:Multilingualism; D009473:Neuronal Plasticity / Q000502:physiology*; D020127:Recovery of Function; D013997:Time Factors