Cognitive and adaptive functioning after severe TBI in school-aged children.

Area of Science:

• Pediatric Neurology
• Neuropsychology
• Rehabilitation Medicine

Background:

• Severe traumatic brain injury (TBI) in children frequently leads to persistent cognitive and behavioral impairments.
• Understanding the specific cognitive and adaptive profiles is crucial for targeted interventions.

Purpose of the Study:

• To investigate the cognitive and adaptive characteristics of school-aged children following severe TBI.
• To identify patterns of deficits and recovery based on injury severity.

Main Methods:

• 118 children with severe TBI were categorized into three groups based on clinical-functional status.
• Functional assessment utilized the Wee-FIM, with reduced responsiveness evaluated by LOCFAS.
• Cognitive and adaptive functioning were assessed using WISC-III, Leiter-R, and VABS for children with better recovery.

Main Results:

• Group 1 (n=77) exhibited borderline cognitive levels with significant deficits in Processing Speed and Perceptual Organization Indices, alongside adaptive behavioral deficits. Coma duration correlated with outcomes.
• Group 2 (n=14) presented with severe language/motor disabilities and moderately impaired cognitive function.
• Group 3 (n=27) consisted of patients with minimal responsiveness (LOCFAS ≤ 3).

Conclusions:

• Within 12 months post-severe TBI, 22.9% of children remained in a minimally responsive state.
• 11.9% experienced debilitating language and motor deficits.
• A significant majority (65.2%) showed more favorable cognitive recovery, allowing for assessment with WISC-III.