title: Pre-school traumatic brain injury and its impact on social development at 8 years of age.
abstract: OBJECTIVE
  To confirm the clinical impression that younger pre-school children (<4 years at time of injury) who are referred to a tertiary care centre for management with moderate-to-severe traumatic brain injury (TBI) have poorer social, cognitive, physical and emotional outcomes compared to older pre-schoolers (4-6 years at time of injury) and to describe the prevalence and severity of their social impairment at 8 years of age.
  
  
  METHODS
  This is a retrospective review of pre-schoolers with moderate-to-severe TBI from 1995-2009. Their social, cognitive, physical and emotional outcomes were assessed at 8 years of age using the Mayo-Portland Adaptability Inventory-Paediatric.
  
  
  RESULTS
  Of 130 pre-schoolers enrolled in the database who sustained a TBI < 6 years, 93 were seen at 8 years of age (57 males, 36 females). Younger pre-schoolers (n = 61, mean 2.6 years) had inferior social outcomes (p = 0.04) and cognitive abilities (p = 0.006), trended toward poorer physical outcomes (p = 0.1), with no difference for emotional outcomes (p = 0.2), compared to older pre-schoolers (n = 32, mean 5.0 years). Overall, 19/93 had normal social function, 38/93 had mild impairment, 21/93 had moderate impairment and 15/93 had severe impairment to social function.
  
  
  CONCLUSIONS
  Children <4 years at the time of moderate-to-severe TBI have poorer social, cognitive and physical outcomes compared to older pre-schoolers.
authors.affiliation: Division of NeuroDevelopmental/NeuroMotor Paediatrics, Glenrose Rehabilitation Hospital, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Lyn K
authors.initials: LK
authors.lastname: Sonnenberg
authors.forename: Annie
authors.initials: A
authors.lastname: Dupuis
authors.forename: Peter G
authors.initials: PG
authors.lastname: Rumney
mesh_terms: D001930:Brain Injuries / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data; D002675:Child, Preschool; D003072:Cognition Disorders / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012919:Social Behavior; D012922:Social Change