Brain injuries in general, but particularly children, have become a focus of more research over the past few years. Few things bring any issue into the public limelight like the NFL focusing on it. Focus on these injuries has also been rising because of how many our fighting men and women have suffered in Iraq and Afghanistan.
That focus on children is greatly expanding our understanding of the seriousness of this issue. The impacts of a brain injury or just “getting your bell rung” on children is an issue we often see as injury lawyers. The Idaho Legislature adopted statutes in 2010 and in the just finished session of 2012 with a legislative response to the safety concerns for youth athletes.
A mild traumatic brain injury is defined as a Glascow coma score of 13-15. There is a persistent myth that the younger the child the more capable they are recovering from traumatic brain injury. Recent research teaches a somewhat different lesson.
Adult brains are more likely to exhibit bleeding due to the atrophy that occurs as one ages. Pediatric brains are still subject to the complications that accompany brain trauma even thought they are less likely to exhibit bleeding. In fact, brain injuries at a younger age pose a “double hazard,” since children have more development ahead of them.
The current research suggests a process where there is no or a limited of initial deficit. But it gradually worsens over time as children fail to develop the age appropriate developmental skills. Consequently early traumatic brain injury can actually have a worse prognosis.
Research is emerging which identifies abnormal patterns of brain activity following head injury. There are specific transient reactions noted in response to traumatic brain injury, which comprises cellular changes at the site of injury and at nearby injury sites. This results in alteration of the general functioning and the overall size of the brain. In such cases, pediatric neurological deficits cannot be seen until the age of 10 to 12 when the frontal lobe processes become fully developed. Until then the child may become proficient at compensating for deficit areas. However, the child may suffer a tremendous decline as the damage to the frontal processes becomes more apparent in adolescence with a decline in school and home functioning. Hannah has already started to exhibit this decline at home.
A recently published meta-analysis of 28 carefully selected articles published between 1988 and 2007 involving children and traumatic brain injury led the author to conclude:
- · The worse the injury, the worse the neurocognitive outcome, especially on measures of general intellectual functioning and processing speed.
- · Time didn’t heal all. The moderate and severe groups were even more similar as time went by, especially on general intellectual functioning and attention/executive skills.
- · Children with traumatic brain injury needed more help, showing robust and significant problems within months on IQ, executive functioning (processing speed, attention), and verbal memory (both immediate and delayed). After two or more years, all areas studied were impaired.
- · Despite some recovery during the first two years, children with traumatic brain injury not only failed to catch up to peers, but appeared to fall further behind over time. Thus, traumatic brain injury may throw off children’s normal developmental timetable.
Babikian et al. Neurocognitive outcomes and recovery after pediatric TBI: Meta-analytic review of the literature.. Neuropsychology, 2009; 23 (3): 283 DOI: 10.1037/a0015268
Similarly, earlier this year the Archives of Pediatrics & Adolescent Medicine reported on a study comparing
almost 200 children and teens ages 8 to 15 who suffered a mild brain injury to about 100 similarly aged children who had a bone injury.
The researchers looked for symptoms of headache, fatigue, inattention and memory problems during the year after the injury.
They found children who suffered a mild brain injury were more likely to show these symptoms compared to other children. Also, the physical symptoms abated sooner in the concussed kids than the problems involving mental, or cognitive, functioning.
This developing research established that injury attorneys dealing with children’s injuries must fully assess a child who suffered a brain trauma in a car collision or otherwise as part of our case evaluation. Making sure that your attorney is aware of and focused on this issues is one aspect of picking the right lawyer.
We have more information on our website Holzer Edwards Chtd. or call us if you have any issues to discuss.