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Cognitive development after traumatic brain injury in young children

Published online by Cambridge University Press:  22 October 2009

AIMEE GERRARD-MORRIS
Affiliation:
Department of Pediatrics, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio
H. GERRY TAYLOR*
Affiliation:
Department of Pediatrics, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio
KEITH OWEN YEATES
Affiliation:
Department of Pediatrics, The Ohio State University, and The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio
NICOLAY CHERTKOFF WALZ
Affiliation:
Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
TERRY STANCIN
Affiliation:
Department of Pediatrics, MetroHealth Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio
NORI MINICH
Affiliation:
Department of Pediatrics, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio
SHARI L. WADE
Affiliation:
Department of Rehabilitation, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
*
*Correspondence and reprint requests to: H. Gerry Taylor, Division of Developmental/Behavioral Pediatrics and Psychology, W.O. Walker Building Suite 3150, 10524 Euclid Ave., Cleveland, OH 44106. E-mail: [email protected]

Abstract

The primary aims of this study were to examine post-injury cognitive development in young children with traumatic brain injury (TBI) and to investigate the role of the proximal family environment in predicting cognitive outcomes. Age at injury was 3–6 years, and TBI was classified as severe (n = 23), moderate (n = 21), and complicated mild (n = 43). A comparison group of children who sustained orthopedic injuries (OI, n = 117) was also recruited. Child cognitive assessments were administered at a post-acute baseline evaluation and repeated at 6, 12, and 18 months post-injury. Assessment of the family environment consisted of baseline measures of learning support and stimulation in the home and of parenting characteristics observed during videotaped parent–child interactions. Relative to the OI group, children with severe TBI group had generalized cognitive deficiencies and those with less severe TBI had weaknesses in visual memory and executive function. Although deficits persisted or emerged across follow-up, more optimal family environments were associated with higher scores for all injury groups. The findings confirm other reports of poor recovery of cognitive skills following early childhood TBI and suggest environmental influences on outcomes. (JINS, 2010, 16, 157–168.)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2009

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