Traumatic brain injury (TBI) may have a profound impact on a child’s ongoing development. Various risk factors have been found to predict outcome, but considerable variability remains unexplained. This study used a prospective, longitudinal design to examine the relationship between recovery, injury severity, age at injury and pre-injury ability. 124 children were divided according to (1) age at injury: ‘young’ (3–7 years) ‘old’ (8–12) and (2) injury severity (mild, moderate, severe). Children were evaluated acutely (T1) and at 12 months post-injury (T2), using standardized intellectual measures (IQ). Results showed a relationship between greater injury severity and poorer IQ. Age at injury was not predictive of outcome for children with mild/moderate TBI. For severe TBI, younger age at injury led to minimal recovery in IQ, while recovery from later injury was similar to that for adults. Findings suggest that children sustaining severe TBI in early childhood may be particularly at risk for residual problems post-injury.

Chadwick O, Rutter M, Shaffer D, Shrout P: A prospective study of children with head injuries. IV. Specific cognitive deficits. J Clin Neuropsychol 1981;2:101–120.
Fay GC, Jaffe KM, Polissar NL, Liao S, Martin KM, Shurtleff HA, Rivara JB, Winn HR: Mild pediatric traumatic brain injury: A cohort study. Arch Phys Med Rehabil 1993;74:895–901.
Fletcher JM, Miner M, Ewing-Cobbs L: Age and recovery from head injury in children: Developmental issues; in Levin H, Eisenberg H, Grafman J (eds): Neurobehavioral Recovery from Head Injury. New York, Oxford University Press, 1987, pp 279–291.
Jaffe KM, Fay GC, Polissar NL, Martin KM, Shurtleff HA, Rivara JB, Winn R: Severity of pediatric traumatic brain injury and neurobehavioral recovery at one year – A cohort study. Arch Phys Med Rehabil 1993;74:587–595.
Kinsella G, Prior M, Sawyer M, Ong B, Murtagh D, Eisenmajer R, Bryan D, Anderson V, Klug G: Predictors and indicators of academic outcome in children 2 years following traumatic head injury. J Int Neuropsychol Soc 1997;3:608–616.
Klonoff H, Low MD, Clark C: Head injuries in children: A prospective five year follow-up. J Neurol Neurosurg Psychiatry 1977;40:1211–1219.
Prigatano GP, O’Brien K, Klonoff PS: Neuropsychological rehabilitation of young adults who suffer brain injury in childhood: Clinical observations. Neuropsychol Rehabil 1993;3:411–421.
Taylor HG, Drotar D, Wade S, Yeates K, Stancin T, Klein S: Recovery from traumatic brain injury in children: The importance of the family; in Broman SH, Michel ME (eds): Traumatic Head Injury in Children. New York, Oxford University Press, 1995, pp 188–218.
Anderson V, Moore C: Age at injury as a predictor of outcome following pediatric head injury. Child Neuropsychol 1995;1:187–202.
Anderson V, Morse SA, Klug G, Catroppa C, Haritou F, Rosenfeld J, Pentland L: Predicting recovery from head injury in school-aged children: A prospective analysis. J Int Neuropsychol Soc 1997;3:568–580.
Ewing-Cobbs L, Fletcher J, Levin H, Francis D, Davidson K, Miner M: Longitudinal neuropsychological outcome in infants and preschoolers with traumatic brain injury. J Int Neuropsychol Soc 1997;3:581–591.
Ponsford J, Willmott C, Rothwell A, Cameron P, Kelly A, Ayton G, Curran C, Nelms R: Cognitive and behavioural outcome following mild traumatic brain injury in children. J Int Neuropsychol Soc 1997;3:225.
Prior M, Kinsella G, Sawyer M, Bryan D, Anderson V: Cognitive and psychosocial outcomes after head injury in childhood. Aust Psychol 1994;29:116–123.
Todd JA, Anderson VA, Lawrence JA: Planning skills in head injured adolescents and their peers. Neuropsychol Rehabil 1996;6:81–99.
Anderson V, Bond L, Catroppa C, Grimwood K, Keir E, Nolan T: Childhood bacterial meningitis: Impact of age at illness and medical complications on long term outcome. J Int Neuropsychol Soc 1997;3:147–158.
Anderson V, Smibert E, Ekert H, Godber T: Intellectual, educational and behavioral sequelae following cranial irradiation and chemotherapy. Arch Dis Child 1994;70:476–483.
Anderson V, Taylor HG: Meningitis in childhood: Neuropsychological implications; in Yeates KO, Ris MD, Taylor HG (eds): Pediatric Neuropsychology: Research, Theory, and Practice. New York, Guilford, in press.
Cousens P, Ungerer JA, Crawford JA, Stevens M: Cognitive effects of childhood leukemia therapy: A case for four specific deficits. J Pediatr Psychol 1988;16:475–488.
Ewing-Cobbs L, Brookshire B, Scott M, Fletcher JM: Children’s narratives following traumatic brain injury: Linguistic structure, cohesion, and thematic recall. Brain Lang 1998;61:395–419.
Gronwall D, Wrightson P, McGinn V: Effect of mild head injury during the preschool years. J Int Neuropsychol Soc 1997;3:592–597.
Taylor H, Alden J: Age-related differences in outcomes following childhood brain insults: An introduction and overview. J Int Neuropsychol Soc 1997;3:555–567.
Tompkins CA, Holland AL, Ratcliff G, Costello A, Leahy L, Cowell V: Predicting cognitive recovery from closed head injury in children and adolescents. Brain Cogn 1990;13:86–97.
Kriel R, Krach L, Panser L: Closed head injury: Comparison of children younger and older than six years of age. Ped Neurol 1989;5:296–300.
Lange-Cosack H, Wider B, Schlesner HJ, Grumme T, Kubicki S: Prognosis of brain injuries in young children (one until five years of age). Neuropaediatrie 1979;10:105–127.
Fletcher J, Ewing-Cobbs L, Francis D, Levin H: Variability in outcomes after traumatic brain injury in children: A developmental perspective; in Broman SH, Michel ME (eds): Traumatic Head Injury in Children. New York, Oxford University Press, 1995, pp 3–21.
Teasdale G, Jennett B: Assessment of coma and impaired consciousness. Lancet 1974;ii:81–84.
Daniel A: Power, Privilege and Prestige: Occupations in Australia. Melbourne, Longman-Cheshire, 1983.
Sparrow S, Balla D, Cicchetti D: The Vineland Adaptive Behavior Scales: Interview Edition, Survey Form Manual. Circle Pines, American Guidance Services, 1984.
Wechsler D: Manual for the Preschool and Primary Intelligence Scale-Revised. New York, Psychological Corporation, 1987.
Wechsler D: Manual for the Wechsler Scale of Children’s Intelligence, Version III. New York, Psychological Corporation, 1991.
Bond M: Assessment of psychosocial outcome after severe head injury; in Porter R, Fitzsimmons DW (eds): Outcome of Severe Damage to the Central Nervous System. Amsterdam, Elsevier, 1975.
Anderson VA, Pentland L: Residual attention deficits following childhood head injury. Neuropsychol Rehabil 1998;8:283–300.
Anderson V, Fenwick T, Manly T, Robertson I: Attentional skills following traumatic brain injury in childhood: A componential analysis. Brain Injury 1998;12:937–949.
Catroppa C, Anderson V, Stargatt R: A prospective analysis of the recovery of attention following pediatric head injury. J Int Neuropsychol Soc 1999;5:48–57.
Ewing-Cobbs L, Miner ME, Fletcher JM, Levin H: Intellectual, language and motor sequelae following closed head injury in infants and preschoolers. J Pediatr Psychol 1989;14:531–547.
Kaufmann PM, Fletcher JM, Levin HS, Miner ME, Ewing-Cobbs L: Attentional disturbance after pediatric closed head injury. J Child Neurol 1993;8:348–353.
Mandleberg IA: Cognitive recovery after severe head injury. 2. Wechsler Adult Intelligence Scale during post-traumatic amnesia. J Neurol Neurosurg Psychiatry 1975;38:1127–1132.
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