Cognitive development after traumatic brain injury in young children.
The primary aims of this study were to examine post-injury cognitive development in young children with traumatic brain injury (TBI) and to investigate the role of the proximal family environment in predicting cognitive outcomes. Age at injury was 3-6 years, and TBI was classified as severe (n = 23), moderate (n = 21), and complicated mild (n = 43). A comparison group of children who sustained orthopedic injuries (OI, n = 117) was also recruited. Child cognitive assessments were administered at a post-acute baseline evaluation and repeated at 6, 12, and 18 months post-injury. Assessment of the family environment consisted of baseline measures of learning support and stimulation in the home and of parenting characteristics observed during videotaped parent-child interactions. Relative to the OI group, children with severe TBI group had generalized cognitive deficiencies and those with less severe TBI had weaknesses in visual memory and executive function. Although deficits persisted or emerged across follow-up, more optimal family environments were associated with higher scores for all injury groups. The findings confirm other reports of poor recovery of cognitive skills following early childhood TBI and suggest environmental influences on outcomes.
Department of Pediatrics, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, OH 43205, USA.
Aimee
A
Gerrard-Morris
H Gerry
HG
Taylor
Keith Owen
KO
Yeates
Nicolay Chertkoff
NC
Walz
Terry
T
Stancin
Nori
N
Minich
Shari L
SL
Wade
D000367:Age Factors; D001930:Brain Injuries / Q000145:classification / Q000150:complications* / Q000523:psychology*; D002648:Child; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology*; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008606:Mental Processes / Q000502:physiology*; D009483:Neuropsychological Tests