Chapter 41 - Sequelae in children: developmental consequences

Abstract

Child traumatic brain injury (TBI) is a major cause of disability in early life. Unlike in adults, a TBI in childhood causes an insult to a brain that is developing, potentially affecting future brain maturation, neural connectivity, and the acquisition of new skills. This review considers how such early brain insult may impact children's functional abilities, and how these processes may link with differential patterns of recovery across infancy, childhood, and adolescence. We also review evidence for cognitive impairment across a range of domains (IQ, attention, processing, memory executive function) and common educational, behavioral, and social consequences associated with child TBI. While impairments in all of these domains have been reported, in fact outcomes from child TBI are surprisingly varied and difficult to predict. To assist in understanding what may contribute to outcomes, we discuss predictive factors (injury severity, child and environment status) and research reporting on their individual and combined effect on recovery. The identification of such outcome predicators has led to an emerging literature in the area of intervention and rehabilitation that we also summarize. Finally, it concludes with discussion of the future direction of pediatric TBI research.