Developmental trajectories of adaptive functioning following early mild traumatic brain injury

Dégeilh, Fanny; Bernier, Annie; Gravel, Jocelyn; Beauchamp, Miriam H.

doi:10.1002/dev.21786

Cited by 20 publications

(15 citation statements)

References 53 publications

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“…For this reason, early brain insult likely affects the maturation of the frontal and temporal cortices, as well as the white matter pathways connecting them to other areas of the brain. Such disruption is known to have detrimental and long-term consequences on the development of critical neurobehavioral functions localized within these regions, such as executive function (10,11), learning and memory (12), emotional control (13), behavioral self-regulation (14), and social adaptive behavior (15).…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Neuroimaging in Pediatric Traumatic Brain Injury: Current State and Consideration of Factors That Influence Recovery

et al. 2019

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Traumatic brain injury (TBI) is a leading cause of death and disability for children and adolescents in the U.S. and other developed and developing countries. Injury to the immature brain varies greatly from that of the mature, adult brain due to numerous developmental, pre-injury, and injury-related factors that work together to influence the trajectory of recovery during the course of typical brain development. Substantial damage to brain structure often underlies subsequent functional limitations that persist for years following pediatric TBI. Advances in neuroimaging have established an important role in the acute management of pediatric TBI, and magnetic resonance imaging (MRI) techniques have a particular relevance for the sequential assessment of long-term consequences from injuries sustained to the developing brain. The present paper will discuss the various factors that influence recovery and review the findings from the present neuroimaging literature to assess altered development and long-term outcome following pediatric TBI. Four MR-based neuroimaging modalities have been used to examine recovery from pediatric TBI longitudinally: (1) T 1 -weighted structural MRI is sensitive to morphological changes in gray matter volume and cortical thickness, (2) diffusion-weighted MRI is sensitive to changes in the microstructural integrity of white matter, (3) MR spectroscopy provides a sensitive assessment of metabolic and neurochemical alterations in the brain, and (4) functional MRI provides insight into the functional changes that occur as a result of structural damage and typical developmental processes. As reviewed in this paper, 13 cohorts have contributed to only 20 studies published to date using neuroimaging to examine longitudinal changes after TBI in pediatric patients. The results of these studies demonstrate considerable heterogeneity in post-injury outcome; however, the existing literature consistently shows that alterations in brain structure, function, and metabolism can persist for an extended period of time post-injury. With larger sample sizes and multi-site cooperation, future studies will be able to further examine potential moderators of outcome, such as the developmental, pre-injury, and injury-related factors discussed in the present review.

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Section: Introductionmentioning

confidence: 99%

Longitudinal Neuroimaging in Pediatric Traumatic Brain Injury: Current State and Consideration of Factors That Influence Recovery

et al. 2019

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“…14 Special attention should be paid to skills that may have been in a critical period of development when the child was injured, such as adaptive behaviors, language, and executive functions, as a growing body of evidence seems to show that these skills are more likely to be negatively impacted. 40,47 Additionally, SLPs should employ both parent interviews and standardized or criterion-referenced assessment tools to try to comprehensively capture the deficits related to TBI, which can be especially challenging in young children due to our limited evidence base regarding assessment. 61 Several assessment tools used in studies included in this review may be useful to SLPs as they consider which standardized assessment tools may differentiate language and cognitive performance in young children with TBI compared with children without injury.…”

Section: Discussion Clinical Implications and Future Directions Formentioning

confidence: 99%

“…14 Eighteen studies reported on psychosocial and behavioral outcomes. 14,16,30,34,37,39,43,[45][46][47][48][49][50][51][52][53][54][55] Generally, social functioning was negatively impacted following early childhood TBI, independent of severity. Acutely, children who experienced a TBI before 6 years of age demonstrated decreased play engagement, including gaze initiation and joint attention.…”

Section: Outcomes Of Early Childhood Tbi and Areas Of Needmentioning

confidence: 97%

“…46,47,56 No significant negative impacts on family measures (e.g., parental distress, general functioning) were observed within 18 months after young children experienced a mild TBI. 46,47 However, in contrast to these findings, Lalonde et al 56 described parent-child interactions after mild TBI and found that the nature and intensity of postconcussive symptoms can negatively impact these interactions. None of the included studies investigated family functioning in the moderate-severe TBI population, and therefore, conclusions should be interpreted with caution.…”

Section: Outcomes Of Early Childhood Tbi and Areas Of Needmentioning

confidence: 99%

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Traumatic Brain Injury in Young Children: A Scoping Review

et al. 2020

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To review the evidence available on early childhood (i.e., 0–5 years 11 months) traumatic brain injury (TBI) and identify clinical implications and future directions for speech-language pathology (SLP) practice and research, a scoping review of the literature was conducted following the 2018 Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRSIMA-ScR) guidelines. A total of 44 peer-reviewed articles were included for review. Included studies were assigned one or more of the following thematic labels related to early childhood TBI: etiology, assessment, treatment, outcomes, contributing factors. Most of the studies were nonexperimental studies and addressed outcomes following early childhood TBI. We conclude, based on this scoping review, that children who experience a TBI before 6 years of age are at risk for persistent long-term difficulties in academic and social functioning. SLPs are among the group of clinicians most appropriate to assess and treat these children; yet, the evidence for assessment, treatment, and identification of factors contributing to the recovery of young children with TBI is particularly lacking. Rigorous research is needed to improve the evidence base for SLPs.

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“…This study was approved by the local institutional ethics review board. Participants were a subgroup recruited as part of a larger prospective longitudinal cohort study aiming to investigate cognitive and social outcomes of early TBI (Bellerose, Bernier, Beaudoin, Gravel, & Beauchamp, ; Dégeilh, Bernier, Gravel, & Beauchamp, ; Gagner, Landry‐Roy, Bernier, Gravel, & Beauchamp, ; Lalonde et al ., ; Landry‐Roy, Bernier, Gravel, & Beauchamp, ). Sixty‐eight children (56% males, M age = 41.9, SD = 11.4 months) with accidental, uncomplicated mTBI aged between 18 and 60 months were recruited over a period of 45 months from December 2011 to August 2015.…”

Section: Methodsmentioning

confidence: 99%

Factors contributing to parent–child interaction quality following mild traumatic brain injury in early childhood

Lalonde

Bernier

Beaudoin

et al. 2019

Journal of Neuropsychology

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There is emerging evidence that parent–child interactions are affected by early childhood traumatic brain injury (TBI). These findings are of functional importance when considering the high prevalence of TBI in early childhood alongside evidence that young children exposed to positive relationships with their parents early in life exhibit better social functioning concurrently and longitudinally. Given that the overall quality of parent–child interactions is the result of both parent and child emotional and behavioural dispositions, it remains unclear which parental or child‐related factors contribute to the quality of interactions post‐TBI. The aim of this study was to investigate the factors that contribute to the quality of parent–child interactions following early childhood TBI. The sample included 68 children (18–60 months at recruitment) with accidental, uncomplicated mild TBI (mTBI). The quality of parent–child interactions was assessed 6 months post‐injury using the Mutually Responsive Orientation scale, an observational measure of the dyadic quality of parent–child exchanges. Potential contributing factors were assessed among parental factors (e.g., age, socioeconomic status, family burden, parental stress, marital satisfaction) and child‐related factors (e.g., age, sex, symptoms, fatigue, adaptive/behavioural skills). Socioeconomic status, child post‐concussive symptoms, and child sleep problems were found to be significant independent contributing factors to parent–child interactions six months post‐injury. This study provides the first evidence that both parental and child factors relate to the quality of parent–child interactions following mTBI, thus contributing to a better understanding of the scope and complexity of factors that play a role in childrens' recovery.

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Developmental trajectories of adaptive functioning following early mild traumatic brain injury

Cited by 20 publications

References 53 publications

Longitudinal Neuroimaging in Pediatric Traumatic Brain Injury: Current State and Consideration of Factors That Influence Recovery

Longitudinal Neuroimaging in Pediatric Traumatic Brain Injury: Current State and Consideration of Factors That Influence Recovery

Traumatic Brain Injury in Young Children: A Scoping Review

Factors contributing to parent–child interaction quality following mild traumatic brain injury in early childhood

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