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Published on: June 20, 2020
Early Elementary School Outcome in Children With a History of Traumatic Brain Injury Before Age 6 Years
Juliet Haarbauer-Krupa1, Tricia Z King, Justin Wise
1Department of Pediatrics (Drs Haarbauer-Krupa and Weissman) and Children's Center for Neuroscience Research Georgia (Dr Weissman), Emory University School of Medicine, Atlanta, Georgia; Children's Healthcare of Atlanta, Atlanta, Georgia (Drs Haarbauer-Krupa and Weissman and Mss Gillam and Trapani); Department of Psychology and the Neuroscience Institute, Georgia State University, Atlanta, Georgia (Dr King); Department of Psychology, Oglethorpe University, Atlanta, Georgia (Drs Wise); and School of Speech-Language Pathology, University of Akron, Ohio (Dr DePompei).
Insights
Children with traumatic brain injury (TBI) before age 6 showed subtle deficits in verbal IQ, language, and executive functions compared to peers with orthopedic injuries, highlighting the need for specialist assessments.
Area of Science:
- Pediatric neurology
- Developmental psychology
- Neuroscience
Background:
- Traumatic brain injury (TBI) in early childhood can impact long-term development.
- Understanding elementary school outcomes is crucial for early intervention.
Purpose of the Study:
- To compare elementary school outcomes in children with pre-age 6 traumatic brain injury (TBI) to a control group with orthopedic injuries.
- To identify specific areas of academic and behavioral differences.
Main Methods:
- Longitudinal study of children aged 6-9 years.
- Utilized child assessments and parent reports for cognitive, language, reading, and behavior.
- Confirmed injuries and severity via medical record review.
Main Results:
- Children with TBI (n=39) primarily had mild complicated TBI.
- Most children performed within normal limits, but TBI group showed differences in verbal IQ, receptive language, and reading comprehension.
- Significant differences noted in pragmatic language, word fluency, and executive functions.
Conclusions:
- Early mild complicated TBI can lead to subtle, yet significant, developmental challenges.
- General evaluations may miss nuanced difficulties; specialist assessments are vital.
- Early identification and intervention are key for children with TBI.
Objective:
To describe elementary school outcomes for children who experienced a traumatic brain injury (TBI) before age 6 years compared with a control group of children with orthopedic injuries.
Participants:
Children ages 6 to 9 years recruited from community and trauma registries in a large southeastern state.
Design:
Descriptive findings from the first year of a 3-year longitudinal study.
Main Measures:
Child assessment and parent report measures were administered to capture cognitive, language, reading, and behavior outcomes. Medical record review confirmed injuries and injury severity.
Results:
The TBI group (n = 39) had a mean age of 7.55 years (standard deviation = 1.29) and was 5.15 (standard deviation = 1.56) years postinjury. The TBI group had primarily classified as mild complicated TBI (63%). On average, children in both groups performed within normal limits on most cognitive, language, and reading measures. Group differences were identified in verbal IQ, receptive language, and reading comprehension, with robust performance differences in pragmatic language, story retell and word fluency, and parent report of executive functions.
Conclusions:
Findings indicate the importance of in-depth follow-up specialist assessments (eg, neuropsychologist and speech and language pathologists) to identify potential nuanced difficulties in children with mild complicated TBI that may be missed by general evaluations.
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