Cognitive and neuroimaging findings in physically abused preschoolers

Aims: To characterise the cognitive, motor, and language skills of toddlers and preschoolers who had been physically abused and to obtain concurrent MRIs of the brain. Methods: A between groups design was used to compare a sample of 19 children, aged 14-77 months, who had been hospitalised for physical abuse with no evidence of neurological injury to a comparison group of 19 children matched for age and socioeconomic status. Children underwent cognitive, language, and motor testing within three months of their discharge from the hospital. Caregivers of the injured children were interviewed and were asked to complete questionnaires to characterise the child's developmental level and behaviour just prior to the hospitalisation. Results: Children who had been physically abused scored significantly lower than the comparison group on measures of cognitive functioning, motor skills, and language skills. The groups did not differ in child behaviour ratings completed by the caregivers. MRI of the brain was performed for 15 children in the physical abuse group; two were found to have significant cerebral atrophy. Conclusions: Children who have been physically abused are at high risk for delays in cognitive, motor, and language development. Standard of care for these children should include developmental testing as well as neuroimaging of the brain to detect occult brain injury.