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Predictors of Cognitive Function and Recovery 10 Years After Traumatic Brain Injury in Young Children
Abstract
BACKGROUND AND OBJECTIVES: Childhood traumatic brain injury (TBI) has implications for functional outcomes, but few studies have documented long-term outcomes. The purpose of this study was to plot recovery of cognitive and functional skills after early childhood TBI to 10 years postinjury and to identify the contribution of injury, environment, preinjury characteristics, and acute functional recovery. METHODS: Subjects were recruited consecutively to this prospective, longitudinal study, which used a between-factor design, with injury severity as the independent variable. Forty children with TBI aged 2 and 7 years were recruited on admission to a tertiary pediatric hospital, divided according to injury severity, and compared with 16 healthy controls acutely and 12 and 30 months and 10 years postinjury. Cognition, adaptive ability, executive function, and social/behavioral skills were examined. RESULTS: Children with severe TBI had poorest outcomes, with deficits greatest for cognition. Recovery trajectories were similar across severity groups but with significant gains in verbal skills from 12 and 30 months to 12 months and 10 years. Predictors of outcome included preinjury ability (for adaptive function) and family function (social/behavioral skills). CONCLUSIONS: Results confirm a high risk of persisting deficits after severe TBI in early childhood. Children with less severe TBI appear to recover to function normally. Contrary to speculation about "growing into deficits," after protracted recovery to 30 months, young children make age-appropriate progress at least to 10 years postinsult. Environmental factors were found to contribute to adaptive and social/behavioral recovery.
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“The neuroplasticity literature is currently mixed and inconclusive, largely due to similar methodological limitations as those outlined above [41–43].”
In the citing paper
“The low-average mean performance on Fluid Cognition in the sTBI group is typical of previous findings reporting neuropsychological outcomes in pediatric TBI (Anderson et al., 2012; Beauchamp et al., 2011; Catroppa & Anderson, 2003; Treble-Barna et al., 2017b).”
From Evaluating cognitive performance using the National Institutes of Health Toolbox Cognitive Battery in children with traumatic brain injury (2025) · cites this paper as Anderson et al., 2012
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“Deficits associated with damage to these areas may only be identified in late adolescents and young adulthood when the functions associated with the prefrontal lobes become critical for optimal functioning, also known as growing into a deficit.(28) Low socioeconomic status could further impedes their success, as this…”
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“An enriching environment is important for optimal development for children (Belsky and de Haan, 2011), and evidence shows that the quality of the environment may play an even greater role in the context of recovery from early brain insult (Anderson et al., 2012; Giza et al., 2005; Greenough et al., 1987).”
BackgroundSelf-citation
Metadata
- Authors
- Anderson, V., Godfrey, C., Rosenfeld, J. V., & Catroppa, C.
- Affiliations
- Royal Children's Hospital (AU)
- Murdoch Children's Research Institute (AU)
- The Alfred Hospital (AU)
- Venue
- PEDIATRICS
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2012-02-01
- Volume
- 129
- Issue
- 2
- Pages
- e254-e261
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2162200017
- Cited by
- 224
- References
- 35
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 9 · 2023: 11 · 2022: 20 · 2021: 17 · 2020: 20 · 2019: 24 · 2018: 15 · 2017: 10 · 2016: 19 · 2015: 22 · 2014: 12 · 2013: 14 · 2012: 11
- FWCI
- 14.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Keywords
- traumatic brain injury, pediatric brain injury, long-term outcomes, cognitive recovery, injury severity, adaptive function, executive function, family functions, verbal ability, recovery trajectories
- MeSH terms
- Adaptation, Psychological, Child, Child Behavior Disorders, Child, Preschool, Cognition Disorders, Disability Evaluation, Family Relations, Female, Humans, Infant, Infant, Newborn, Intelligence, Language Development Disorders, Longitudinal Studies, Male, Prognosis, Prospective Studies, Social Environment, Glasgow Coma Scale, Parenting, Brain Injury, Chronic, Family Conflict, Executive Function
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