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The effects of head injury in children on neuropsychological and behavioural functioning
R M Knights1, L P Ivan, E C Ventureyra
1Department of Psychology and Neurosurgery, Children's Hospital of Eastern Ontario, Ottawa, Canada.
Insights
Children with severe head injuries show significant cognitive deficits, particularly in visual-motor skills. Most children with severe injuries experience behavioral changes, while recovery is most rapid in the first three months post-injury.
Area of Science:
- Pediatric Neurology
- Neuropsychology
- Traumatic Brain Injury
Background:
- Head injuries in children can lead to long-term cognitive and behavioral issues.
- Assessing the impact of injury severity on neurodevelopmental outcomes is crucial.
Purpose of the Study:
- To investigate the relationship between head injury severity and neuropsychological outcomes in children.
- To evaluate the time course of cognitive recovery and behavioral changes following pediatric head injury.
Main Methods:
- Prospective study of 76 children categorized by Glasgow Coma Scale and intracranial pressure.
- Neuropsychological testing and behavioral ratings (parents/teachers) at discharge, 3, and 9 months post-injury.
Main Results:
- Cognitive deficits correlated with injury severity, most pronounced in the severe group (Performance IQ, visual-motor speed).
- Greatest cognitive improvement observed within the first 3 months post-injury.
- Severe head injury group (90%) experienced learning/adjustment difficulties, unlike mild/moderate groups.
Conclusions:
- Head injury severity significantly impacts cognitive function and behavior in children.
- Early intervention and monitoring are essential for children with severe head injuries.
- Recovery is possible even after prolonged coma, but behavioral sequelae are common in severe cases.
Abstract:
In a prospective study 76 children were divided into three groups on the basis of severity of head injury as defined by the Glasgow Coma Scale and duration of increased intracranial pressure. The children were administered a neuropsychological test battery and behavioural ratings were made by parents and teachers at three intervals: time of hospital discharge and 3 and 9 months post-initial testing. There were cognitive deficits related to severity of injury with the greatest difference in abilities observed between the severe and the other two groups. The greatest differences in skills were on the Performance IQ and timed tests of visual-motor speed and co-ordination. The greatest improvement in skills occurred in the first 3 months post-injury. Several children in coma for up to 4 weeks were able to obtain normal IQ scores. In the mild and moderate injury groups very few had behavioural change while in the severe group approximately 90% had one learning or adjustment difficulty and 40% had three or more problems.