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The effect of pediatric traumatic brain injury on behavioral outcomes: a systematic review
1School of Nursing, University of Pennsylvania, Philadelphia, PA 19104-4217, USA.
Insights
Children with traumatic brain injury (TBI) face a high risk of developing persistent behavioral problems. Family environment significantly influences these outcomes, highlighting the need for supportive interventions.
Area of Science:
- Pediatric neurology
- Developmental psychology
- Neuroscience
Background:
- Childhood traumatic brain injury (TBI) is a significant concern.
- TBI can lead to long-term neurodevelopmental and behavioral consequences.
Purpose of the Study:
- To systematically review empirical evidence linking childhood TBI to subsequent behavioral problems.
- To identify risk factors and protective factors for behavioral outcomes after pediatric TBI.
Main Methods:
- Systematic literature search of PubMed and Web of Knowledge (1990-2012).
- Inclusion of original research studies on children (0-18 years) with TBI and behavioral outcomes.
- Analysis of 50 diverse studies.
Main Results:
- Up to 50% of children with TBI are at risk for behavioral problems and disorders.
- Behavioral issues can manifest early or years post-injury, often persisting or worsening.
- Family environment moderates the severity and persistence of behavioral impairments.
Conclusions:
- Childhood TBI survivors are prone to sustained behavioral impairments.
- Further research is needed on cognitive and environmental factors influencing TBI-related behavioral issues.
- Healthcare providers and caregivers play crucial roles in monitoring and mitigating these problems through assessment and supportive environments.
Aim:
To review systematically the empirical evidence on traumatic brain injury (TBI) during childhood and subsequent behavioral problems.
Method:
An initial literature search with keywords 'brain injury,''children,' and 'behavior' was conducted using Web of Knowledge and PubMed databases. Ancestry was also used. Original research studies published between 1990 and February 2012 focusing on behavioral outcomes of children sustaining TBI from ages 0 to 18 years were included.
Results:
Fifty studies, varying considerably in methodologies, were included in the review. Findings showed that up to 50% of brain-injured children are at risk for presenting with specific behavioral problems and disorders. These problems may emerge shortly or several years after injury and often persist and even worsen with time. These behavioral impairments appear to be moderated by the family environment.
Interpretation:
Survivors of childhood TBI are at risk for developing and sustaining behavioral impairments. Stronger research is needed to identify cognitive and environmental factors that contribute to the onset and maintenance of these problems. Healthcare providers should ensure adequate follow-up and assessment of a child's behavioral, social, and neurocognitive domains. Caregivers should be encouraged to provide positive environments and parenting styles, which may help reduce chronic behavioral problems after brain injury.
