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Published on: August 25, 2014
Early developmental, behavioral, and quality of life outcomes following abusive head trauma in infants
Emily A Eismann1, Jack Theuerling1, Amy Cassedy2
1Mayerson Center for Safe and Healthy Children, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA.
Insights
Developmental delays and behavioral issues are common in infants after abusive head trauma. Long-term follow-up is crucial as these problems may emerge later.
Area of Science:
- Pediatric neurology
- Child development
- Trauma research
Background:
- Pediatric abusive head trauma (AHT) frequently leads to developmental delays.
- Understanding long-term outcomes is essential for early intervention and care.
Purpose of the Study:
- To evaluate developmental, behavioral, and quality of life outcomes in infants following AHT.
- To identify injury severity and early therapeutic intervention as predictors of these outcomes.
Main Methods:
- Infants under 12 months with AHT were followed for up to 3 years.
- Development was assessed using Mullen Scales of Early Learning.
- Behavior and quality of life were evaluated using Child Behavior Checklist and PedsQL™.
Main Results:
- Cognitive development, fine motor, and expressive language declined with age.
- Outcomes varied significantly by injury severity.
- Early intervention did not show significant associations with improved outcomes.
Conclusions:
- Children with AHT require long-term, comprehensive follow-up.
- Developmental delays and behavioral problems may manifest later in childhood.
Background:
Developmental delays following pediatric abusive head trauma are common.
Objective:
To assess early developmental, behavioral, and quality of life outcomes following infant abusive head trauma and evaluate injury severity and early therapeutic intervention as potential predictors.
Participants And Setting:
Infants under 12 months old who were admitted to a large pediatric hospital with abusive head trauma between October 2010 and October 2017 and followed at a multidisciplinary post-injury clinic were included.
Methods:
Injury severity groups were classified based on days in the Pediatric Intensive Care Unit. Participation in early intervention services and/or physical or occupational therapy by the first clinic visit was documented. Development was assessed using the Mullen Scales of Early Learning, which 47 patients completed at approximately 6 month intervals up to 3 years of age (an average of 19 months post-injury). Behavior and quality of life were assessed around age 2 using the Child Behavior Checklist (n = 24) and PedsQL™ (n = 27), respectively.
Results:
Overall cognitive development, fine motor function, and expressive language significantly declined with age up to 3 years (p < 0.05). The changes in these developmental scales with age differed significantly between injury severity groups (p < 0.05). Internalizing behaviors were also greater in patients with moderate than mild injuries (t = 2.37, p = 0.037). Quality of life was comparable to healthy populations. Early therapeutic intervention was not significantly associated with developmental, behavioral, or quality of life outcomes (p > 0.05).
Conclusions:
Long-term comprehensive follow-up is recommended for children following abusive head trauma, as developmental delays and behavioral problems may present at later ages.
