Intellectual, behavioral, and social outcomes of accidental traumatic brain injury in early childhood.

OBJECTIVE The intellectual, behavioral, and social function of children who sustained traumatic brain injury (TBI) before 3 years of age were compared with a group of uninjured children. The role of injury and environmental factors in recovery was examined. METHODS A group of 53 children who sustained a TBI before 3 years of age (20 mild and 33 moderate/severe) and 27 uninjured children (control group) were assessed on an IQ measure and parent measures of behavior and social skills. Children were aged 4 to 6 years and were an average of 40 months since sustaining their injury. RESULTS There were no demographic differences between the groups. Although all group scores were in the average range, children with moderate/severe TBI performed significantly below uninjured children on an IQ measure. No significant differences were found on parent behavior ratings, although effect sizes between groups were medium to large. No differences were found for social skills. All outcomes were significantly influenced by environmental but not injury factors. CONCLUSIONS Moderate/severe TBI at an early age appears to be associated with lowered intellectual function and possibly behavior problems. A child's environment influences cognitive and behavior function after TBI.