title: Does early age at brain insult predict worse outcome? Neuropsychological implications.
abstract: OBJECTIVE
  Traditionally early brain insult (EBI) has been argued to have better outcome than later injury, consistent with the notion that the young brain is flexible and able to reorganize. This view was investigated by comparing neurobehavioral outcomes of children sustaining EBI at different developmental stages (gestation to late childhood).
  
  
  METHODS
  One hundred and sixty four children who had sustained focal brain insult (confirmed by MRI) formed six groups, based on age at EBI, (a) Congenital; (b) Peri-natal; (c) Infancy; (d) Preschool; (e) Middle Childhood; (f) Late Childhood, and were compared on a range of standardized neurobehavioral measures. Groups were matched for lesion characteristics and demographics.
  
  
  RESULTS
  Children sustaining EBI before age 2 recorded global deficits, while children with later EBI performed closer to average.
  
  
  CONCLUSIONS
  These results question the advantages of early brain plasticity, demonstrating poorer outcome from very early insults, and increasingly better function with lesions later in childhood.
authors.affiliation: Department of Psychology, Royal Children's Hospital, Flemington Road, Parkville, Victoria, 3052, Australia. vicki.anderson@rch.org.au
authors.forename: Vicki
authors.initials: V
authors.lastname: Anderson
authors.forename: Rani
authors.initials: R
authors.lastname: Jacobs
authors.forename: Megan
authors.initials: M
authors.lastname: Spencer-Smith
authors.forename: Lee
authors.initials: L
authors.lastname: Coleman
authors.forename: Peter
authors.initials: P
authors.lastname: Anderson
authors.forename: Jackie
authors.initials: J
authors.lastname: Williams
authors.forename: Mardee
authors.initials: M
authors.lastname: Greenham
authors.forename: Rick
authors.initials: R
authors.lastname: Leventer
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000704:Analysis of Variance; D001288:Attention; D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D001930:Brain Injuries / Q000473:pathology / Q000503:physiopathology*; D002648:Child; D056344:Executive Function; D005260:Female; D006801:Humans; D007223:Infant; D007804:Language Development; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests