Late intellectual and academic outcomes following traumatic brain injury sustained during early childhood

被引:200
作者
Ewing-Cobbs, Linda
Prasad, Mary R.
Kramer, Larry
Cox, Charles S., Jr.
Baumgartner, James
Fletcher, Stephen
Mendez, Donna
Barnes, Marcia
Zhang, Xiaoling
Swank, Paul
机构
[1] Univ Texas, Hlth Sci Ctr, Dept Pediat, Houston, TX 77030 USA
[2] Univ Texas, Hlth Sci Ctr, Dept Radiol, Houston, TX 77030 USA
[3] Univ Texas, Hlth Sci Ctr, Dept Surg, Houston, TX 77030 USA
[4] Univ Texas, Hlth Sci Ctr, Dept Neurosurg, Houston, TX 77030 USA
[5] Baylor Coll Med, Dept Emergency Med, Houston, TX 77030 USA
[6] Univ Guelph, Dept Psychol, Guelph, ON N1G 2W1, Canada
关键词
traumatic brain injury; shaken baby syndrome; academic performance; cognitive outcome; pediatric neurosurgery;
D O I
10.3171/ped.2006.105.4.287
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Object. Although long-term neurological outcomes after traumatic brain injury (TBI) sustained early in life are generally unfavorable, the effect of TBI on the development of academic competencies is unknown. The present study characterizes intelligence quotient (IQ) and academic outcomes an average of 5.7 years after injury in children who sustained moderate to severe TBI prior to 6 years of age. Methods. Twenty-three children who suffered inflicted or noninflicted TBI between the ages of 4 and 71 months were enrolled in a prospective, longitudinal cohort study. Their mean age at injury was 21 months; their mean age at assessment was 89 months. The authors used general linear modeling approaches to compare IQ and standardized academic achievement test scores from the TBI group and a community comparison group (21 children). Children who sustained early TBI scored significantly lower than children in the comparison group on intelligence tests and in the reading, mathematical, and language domains of achievement tests. Forty-eight percent of the TBI group had IQs below the 10th percentile. During the approximately 5-year follow-up period, longitudinal IQ testing revealed continuing deficits and no recovery of function. Both IQ and academic achievement test scores were significantly related to the number of intracranial lesions and the lowest postresuscitation Glasgow Coma Scale score but not to age at the time of injury. Nearly 50 % of the TBI group failed a school grade and/or required placement in self-contained special education classrooms; the odds of unfavorable academic performance were 18 times higher for the TBI group than the comparison group. Conclusions. Traumatic brain injury sustained early in life has significant and persistent consequences for the development of intellectual and academic functions and deleterious effects on academic performance.
引用
收藏
页码:287 / 296
页数:10
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