In this article, the authors provide a comprehensive review of the research of mild head injury in children and adolescents from 1970 to 1995. Because of marked variability in methodologies across studies, a preliminary box-score tally was computed, without regard to studies' scientific or methodological merit. These results revealed 13 adverse, 18 null, and 9 indeterminate findings related to neuropsychological, academic, or psychosocial outcome. When studies were classified based on methodological merit, the stronger studies were generally associated with null outcomes across domains. However, a few of the less stronger neuropsychological studies (5 of 40) reported subthreshold and transitory alterations during the early postinjury period. At the present time, cautious acceptance of the null hypothesis is recommended until more definitive studies are conducted that address the problems raised in this review.

Comprehensive reviews of neurocognitive outcomes following mild, uncomplicated traumatic brain injury (TBI) in children have shown minimal effects on neurocognition, especially in methodologically rigorous studies. In this study, we report longitudinal (1, 6, and 12 months post injury) results in four domains of neurocognitive functioning in a large sample of children with mild TBI (n = 124, ages 8–17 at injury) relative to two demographically matched control groups (other injury: n = 94 and non-injury: n = 106). After accounting for age and parental education, significant main effects of group were observed on 7 of the 10 neurocognitive tests. However, these differences were not unique to the TBI sample but were found between both the TBI and other injury groups relative to the non-injured group, suggesting a general injury effect. Effects were primarily within the domains measuring memory, psychomotor processing speed, and language. This is the largest longitudinal study to date of neurocognitive outcomes at discrete time points in pediatric mild TBI. When controlling for pre-injury factors, there is no evidence of long-term neurocognitive impairment in this group relative to another injury control group. The importance of longitudinal analyses and use of appropriate control groups are discussed in the context of evaluating the effects of mild TBI on cognition.

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