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Behavioral changes after closed head injury in children.

J M Fletcher1, L Ewing-Cobbs, M E Miner

  • 1Department of Pediatrics, University of Texas Medical School, Houston 77030.

Journal of Consulting and Clinical Psychology
|February 1, 1990
PubMed
Summary

Children with severe head injuries showed lasting behavioral declines. Mild and moderate injuries did not significantly impact behavior over 12 months post-injury.

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Area of Science:

  • Neuroscience
  • Pediatric Psychology
  • Rehabilitation Medicine

Background:

  • Closed head injuries (CHIs) in children can lead to long-term behavioral and adaptive functioning deficits.
  • Understanding the trajectory of behavioral adjustment following pediatric CHI is crucial for effective intervention.
  • Previous research indicates varying outcomes based on injury severity, but longitudinal data is essential.

Purpose of the Study:

  • To longitudinally assess the behavioral adjustment of children following mild, moderate, and severe closed head injuries.
  • To compare the adaptive functioning and behavioral changes over a 12-month period across different injury severity groups.
  • To identify specific areas of behavioral difficulty associated with severe pediatric head trauma.

Main Methods:

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  • A longitudinal study followed 45 children with mild, moderate, or severe closed head injuries.
  • Parental reports using the Child Behavior Checklist (CBCL) and Vineland Adaptive Behavior Scales (VABS) were collected at baseline, 6, and 12 months post-injury.
  • Statistical analyses compared behavioral outcomes between injury severity groups over time.

    • Main Results:

    • Children with severe closed head injuries demonstrated significantly poorer adaptive functioning on the VABS throughout the 12-month follow-up compared to those with mild and moderate injuries.
    • On the CBCL, severely injured children exhibited more school-related problems and reduced social engagement.
    • Children with mild and moderate head injuries showed no significant behavioral differences from each other or from average levels at any follow-up point.

    Conclusions:

    • Severe closed head injuries in children are associated with persistent declines in adaptive functioning and increased behavioral problems.
    • Mild and moderate head injuries in children do not appear to result in significant long-term behavioral deviations.
    • These findings underscore the critical impact of head injury severity on pediatric behavioral outcomes and highlight the need for targeted support for severely injured children.