Neurocognitive outcomes and recovery after pediatric TBI: meta-analytic review of the literature
Open accessAbstract
Traumatic Brain Injury (TBI) continues to be one of the leading causes of death and disability in the pediatric population. Although the literature on neurocognitive outcomes is relatively rich, studies vary significantly in the methods used to group subjects on several moderating variables, including age at injury, injury severity, and time since injury, making it difficult to combine and summarize the data for comparison. Further complicating this effort is the wide range of measures used to document functional outcomes in key neurocognitive domains. In this meta-analytic review, 28 publications (1988 to 2007) that met inclusion criteria were summarized based on three distinct injury severity and time post injury groups for 14 key neurocognitive domains. Effect sizes were calculated to reflect the extent to which the above groups differed in case-control and case-case studies, as well as address recovery based on longitudinal studies. To the best of our knowledge, this is the first published quantitative summary of the literature on neurocognitive outcomes after pediatric TBI. Limitations of the current state of the literature as well as recommendations for future studies are discussed.
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Previous studies show that children with mild TBI and complicated mild TBI generally demonstrate few deficits in cognitive performance after three months post-injury, while children with severe TBI demonstrate consistently poorer cognitive performance compared to children with orthopedic injury.
“Previous studies show that children with mild TBI and complicated mild TBI generally demonstrate few deficits in cognitive performance after three months post-injury, while children with sTBI demonstrate consistently poorer cognitive performance compared to children with OI (Babikian & Asarnow, 2009; Chadwick et al., 2021; Keenan et al., 2018).”
From Evaluating cognitive performance using the National Institutes of Health Toolbox Cognitive Battery in children with traumatic brain injury (2025) · cites this paper as Babikian & Asarnow, 2009
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Experimental — accuracy not yet measuredPerformance on the crystalized composite is not impervious to the effects of neurological injury, considering verbal intelligence can be reduced in acute and chronic pediatric brain injury.
“it is not impervious to the effects of neurological injury, considering verbal intelligence can be reduced in acute and chronic pediatric brain injury (Babikian and Asarnow, 2009).”
From Cognitive weaknesses or impairments on the NIH toolbox cognition battery in children and adolescents: base rates in a normative sample and proposed methods for classification (2025) · cites this paper as Babikian and Asarnow, 2009
The Results (Outcomes After Severe TBI; page unavailable) report reduced verbal IQ relative to controls at Time 1 and a larger difference at Time 3, supporting the point that verbal intelligence is vulnerable after pediatric TBI. The Method defines Time 1 as postacute (0–5 months), not acute, and Time 3 as chronic; the paper therefore does not establish the claim for the acute phase as stated. (LLM, conf=0.82)
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- Authors
- Babikian, T., & Asarnow, R.
- Affiliations
- University of California, Los Angeles (US)
- Venue
- Neuropsychology
- Published
- 2009-05
- Volume
- 23
- Issue
- 3
- Pages
- 283-296
- ISSN
- 0894-4105 (ISSN-L)
- 1931-1559
- PMC
- PMC4064005
- OpenAlex
- W2111128053
- Cited by
- 557
- References
- 5
- Citations by year
- 2026: 19 · 2025: 25 · 2024: 30 · 2023: 28 · 2022: 36 · 2021: 29 · 2020: 44 · 2019: 36 · 2018: 85 · 2017: 38 · 2016: 27 · 2015: 39 · 2014: 23 · 2013: 22 · 2012: 26
- FWCI
- 17.31
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Neuropsychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (F32NS053169)
- Della Martin Foundation
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Automotive and Human Injury Biomechanics
- Keywords
- pediatric traumatic brain injury, neuropsychological outcomes, recovery, injury severity, age at injury, time since injury, cognitive domain, functional outcome, longitudinal recovery
- MeSH terms
- Brain Injuries, Child, Cognition, Humans, Neuropsychological Tests, Pediatrics, Prognosis, Psychomotor Performance, Severity of Illness Index, Recovery of Function
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