Research on outcomes of pediatric traumatic brain injury: current advances and future directions

The articles in this series demonstrate the diversity of research approaches needed to enhance understanding of the sequelae of traumatic brain injury (TBI) in children. Methods ranged from assessment of information processing deficits to evaluation of the construct validity of cognitive tests, tracking of changes in academic achievement after injury, and measurement of behavior and social outcomes. Several articles considered multiple influences on sequelae, including TBI severity, age at injury, time since injury, and preinjury child characteristics. The findings provide new information on injury consequences and the cognitive correlates of postinjury problems in behavior, achievement, and discourse processing. Continued progress requires additional study of relations between specific forms of neuropathology and outcomes, more comprehensive assessments of environmental influences, and greater efforts to monitor postinjury developmental changes. Other needs include more probing assessments of the effects of TBI on daily functioning and social-emotional outcomes, investigation of the specificity of sequelae and of sources of variability in outcome, and application of models that examine mechanisms of effect. This research will benefit clinical practice, clarify processes underlying children's behavior and learning problems, and advance knowledge of normal development.