title: Early attention impairment and recovery profiles after childhood traumatic brain injury.
abstract: OBJECTIVE
  To examine recovery of attention from 3 to 6 months postinjury; to identify effects of injury severity and time since injury on performance; to explore whether complex attention skills (eg, shifting, divided attention, attentional control) are more vulnerable to traumatic brain injury (TBI), and slower to recover than simple attention skills (eg, attentional capacity, selective attention, sustained attention).
  
  
  METHODS
  Prospective longitudinal investigation.
  
  
  METHODS
  A total of 205 school-aged children with TBI were divided into groups according to injury severity (mild = 63%, moderate = 27%, severe = 10%).
  
  
  METHODS
  Emergency departments of 3 metropolitan children's hospitals across Australia.
  
  
  METHODS
  Standardized clinical measures of both simple and complex attention were administered at 3 months and 6 months postinjury.
  
  
  RESULTS
  Attention skills were vulnerable to the impact of TBI. More severe injury affected attention skills most negatively. Significant recovery was observed over time. There were few interaction effects, with severity groups exhibiting similar levels of recovery over the 6 months post-TBI. No differences in recovery trajectories were detected for simple and complex attention.
  
  
  CONCLUSIONS
  These findings have important clinical and educational implications, suggesting that children with TBI, and particularly those with more serious injuries, are most vulnerable to attention deficits in the acute stages postinjury. It is important that schools and families are aware of these limitations and structure expectations accordingly. For example, gradual return to school should be considered, and in the early stages of recovery, children should be provided with sufficient rest time, with reduced expectations for tasks such as homework.
authors.affiliation: Critical Care and Neuroscience, Murdoch Childrens Research Institute, Melbourne, Australia. vicki.anderson@rch.org.au
authors.forename: Vicki
authors.initials: V
authors.lastname: Anderson
authors.forename: Senem
authors.initials: S
authors.lastname: Eren
authors.forename: Rian
authors.initials: R
authors.lastname: Dob
authors.forename: Robyne
authors.initials: R
authors.lastname: Le Brocque
authors.forename: Greg
authors.initials: G
authors.lastname: Iselin
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Davern
authors.forename: Lynne
authors.initials: L
authors.lastname: McKinlay
authors.forename: Justin
authors.initials: J
authors.lastname: Kenardy
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001288:Attention; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D001315:Australia; D001930:Brain Injuries / Q000150:complications* / Q000175:diagnosis* / Q000534:rehabilitation; D002648:Child; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D009483:Neuropsychological Tests; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function; D018570:Risk Assessment; D013997:Time Factors; D015599:Trauma Severity Indices