Young children who suffer a severe head blow may not overcome the traumatic brain injury (TBI) as well as previously believed, and interventions may be needed even years after, according to two new studies out of Australia.
For the first study, Australian researchers looked at 56 children, 40 of whom were injured between ages 2 and 7 and the other 16 who served as a control group. They found that a decade after each of the 40 suffered a TBI, evidence persisted of intellectual deficits. The study is published this week in the journal Pediatrics online and will be included in February's issue.
They looked at the intellectual, adaptive and executive abilities of the children, as well as their social/behavioral skills. Those with severe TBI tested lowest on IQ exams compared to a control group — as much as 18 to 26 points lower. They also found that regardless of how serious the injury was, recovery "seemed to plateau in the five- to 10-year range," the researchers said.
A release announcing the findings noted that "this is important because it counters the theory that children 'grow into the deficits' and suggests that even many years post-TBI, intervention may be necessary and helpful."
Most of the children in this study were injured by car accidents or a serious fall. They were tested at the time of their injury, then tested again three, six and 18 months after the injury, as well as again at five years and 10 years.
The findings apply to major brain trauma, not to cases of mild concussion or bumps on the head.
"Most of the deficits occurred in higher learning skills such as organization, planning and reasoning, because these are centered in the frontal regions of the brain, which are most often affected in head injuries," wrote Alice Park on a blog for Time magazine.
"These regions are also the ones that develop fastest early in life, so any injury that disrupts the normal trajectory of nerve growth can have long-lasting effects," said lead author Vicki Anderson, director of critical care and neuroscience research at Murdoch Children's Research Institute in Melbourne, Australia. Scientists have long talked about the brain's plasticity and its remarkable ability to reroute signals when something injures the brain. Some researchers believe that injuries to very young children are more apt to be overcome for that very reason than brain injuries in older children and adults. But Anderson noted that young children's brains are not fully developed and, after injury, development lags and may not catch up. "If you look at the trajectory of improvement over time, normal kids have one trajectory, while those with brain injuries have the same trajectory but start out at a much lower point," Anderson told Time.
The study did note a positive: Brain development after a traumatic brain injury does not appear to grind to a halt, as some had theorized.
The other study, also published in Pediatrics this week, found that socioeconomic status might be an even stronger predictor of intellectual development than simply having suffered a traumatic injury to the brain. They told CNN that lower socioeconomic status, high parental stress and low parental involvement affect a child's recovery after TBI and that might account for it.
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