Outcomes of child abuse

The limited research available regarding the outcome of inflicted TBI suggests that this type of injury may be especially deleterious to infants and young children. It is likely that mechanisms of injury, age at injury, and circumstances of injury (i.e., child abuse and maltreatment) all contribute to these findings. Until recently, the investigations of TBI and child abuse and maltreatment have occurred on two separate tracks. The review of these two literatures indicates that the TBI outcome literature is strongly grounded in neuropsychologic methodology, whereas the child abuse and maltreatment literature depends most heavily on less brain-specific measures of general intellectual ability and academic achievement. The evidence reviewed here suggests that it is time for these areas of research to converge. Children with inflicted head injury should be evaluated not only to assess outcome related to TBI but to disconfirm the presence of PTSD, a developmental disorder that may also result in CNS changes. In this vulnerable population, longitudinal assessment well past the period of initial insult is imperative to assess the rate of development of skills, to identify deficient areas, and to plan appropriate interventions.