title: Predictors of cognitive function and recovery 10 years after traumatic brain injury in young children.
abstract: OBJECTIVE
  Childhood traumatic brain injury (TBI) has implications for functional outcomes, but few studies have documented long-term outcomes. The purpose of this study was to plot recovery of cognitive and functional skills after early childhood TBI to 10 years postinjury and to identify the contribution of injury, environment, preinjury characteristics, and acute functional recovery.
  
  
  METHODS
  Subjects were recruited consecutively to this prospective, longitudinal study, which used a between-factor design, with injury severity as the independent variable. Forty children with TBI aged 2 and 7 years were recruited on admission to a tertiary pediatric hospital, divided according to injury severity, and compared with 16 healthy controls acutely and 12 and 30 months and 10 years postinjury. Cognition, adaptive ability, executive function, and social/behavioral skills were examined.
  
  
  RESULTS
  Children with severe TBI had poorest outcomes, with deficits greatest for cognition. Recovery trajectories were similar across severity groups but with significant gains in verbal skills from 12 and 30 months to 12 months and 10 years. Predictors of outcome included preinjury ability (for adaptive function) and family function (social/behavioral skills).
  
  
  CONCLUSIONS
  Results confirm a high risk of persisting deficits after severe TBI in early childhood. Children with less severe TBI appear to recover to function normally. Contrary to speculation about "growing into deficits," after protracted recovery to 30 months, young children make age-appropriate progress at least to 10 years postinsult. Environmental factors were found to contribute to adaptive and social/behavioral recovery.
authors.affiliation: Department of Psychology, Royal Children's Hospital, Parkville, Victoria, 3052 Australia. vicki.anderson@rch.org.au
authors.forename: Vicki
authors.initials: V
authors.lastname: Anderson
authors.forename: Celia
authors.initials: C
authors.lastname: Godfrey
authors.forename: Jeffrey V
authors.initials: JV
authors.lastname: Rosenfeld
authors.forename: Cathy
authors.initials: C
authors.lastname: Catroppa
mesh_terms: D000223:Adaptation, Psychological; D020208:Brain Injury, Chronic / Q000175:diagnosis* / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000523:psychology; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D004185:Disability Evaluation; D056344:Executive Function; D054541:Family Conflict / Q000523:psychology; D005195:Family Relations; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007360:Intelligence; D007805:Language Development Disorders / Q000175:diagnosis / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D016487:Parenting / Q000523:psychology; D011379:Prognosis; D011446:Prospective Studies; D012931:Social Environment