Neurobehavioral outcomes after early versus late childhood traumatic brain injury

OBJECTIVES: To examine differences in outcomes at transition age (17-21 years) between individuals who sustained complicated mild-to-severe traumatic brain injury (TBI) in early or middle childhood and those who were injured in late adolescence. PARTICIPANTS: Fifteen persons who sustained TBI between the ages of 6 and 12 years (early-onset) and 30 persons who sustained TBI between the ages of 16 and 20 years (late-onset). MEASURES: Peabody Picture Vocabulary Test-Third Edition, Trail-Making Test, Buschke Selective Reminding Test, Benton Visual Retention Test, Dysexecutive Questionnaire, Community Integration Questionnaire, Satisfaction with Life Scale. RESULTS: The groups did not differ in overall cognitive ability level, postinjury education or vocational accomplishments, or current living situation. However the early-onset group demonstrated worse outcomes in higher-level cognitive skills, social integration, driving, and legal guardianship. CONCLUSIONS: Complicated mild-to-severe TBI earlier in childhood is associated with worse long-term neurocognitive and psychosocial outcomes than injury sustained in late adolescence. Findings provide further support for theories that early brain injury onset interferes with development of immature or rapidly developing skills, and may be associated with further magnification of deficits during the course of later development.