Childhood Head Injuries May Heal Over Time

A new study by Australian researchers shows that childhood head injuries, which affect the development of children, can improve over time. The poorest recovery was seen with severe brain injury, while children with less severe injuries did not have many serious problems later. According to the study, children have an injury threshold that they show developmental progress, although they may not be able to catch up with the peers totally.

According to study researcher Vicki Anderson, PhD, professor of pediatrics and psychology at the University of Melbourne, environment matters in recovery. By optimizing the child’s environment, one can help to improve the outcome of the injury for the child. “For example, a stimulating environment at home will be helpful for the child to have a better recovery”, says Anderson, who is also director of critical care and neuroscience research at Murdoch Children’s Research Institute at Royal Children's Hospital.

As per another study, 1 in 30 newborns will have a traumatic injury by the age of 16-years-old. The injuries tend to persist for another five years, but it is not clear which factors are important in a quick recovery. In this study, published in the journal, Pediatrics, about 40 children who had head injuries, when they were between the ages of 2-years-old and 7-years-old years old, were studied for 10 years.

The children were divided into three groups:

• Those with minor injuries, numbering seven in total
• Those with moderate injuries, numbering 20
• Those with severe injuries, numbering 13

“Usually a fall causes a mild injury while accidents result in severe brain injury”, says Anderson. The researchers compared the children with brain injury with those who did not have any injuries to the brain. All the participants took up tests on IQ, thinking skills, and social and behavioral skills. Their adaptive skills like responses to the daily requirements and specific learning difficulties were also measured. These tests were taken after the accident and once after 12 months, 30 months, and 10 years.

Worst outcomes were noted in children with severe brain injuries. “The outcomes were very poor especially for thinking skills”, says Anderson. IQ levels for those who had severe injuries were at the lower end of average or below-average. The IQ scores were 18 to 26 points lower when compared to healthy children without brain injuries.

Time was the most important factor for recovery, according to Anderson. The trajectories of recovery show a plateau from five to ten years, she says. It is after this time period that children stabilize and make gains. Children will improve with continued treatment. This study gave a contradictory result to the earlier belief that children with brain injury do not show any improvement. In fact, there is a general belief that children with brain injuries get worse as time goes on, says Anderson. As per the study, the negative impacts of the injury stabilize after two to three years and they get better. They may not be able to catch up with their peer group, adds Anderson. Results also showed that being in a psychologically healthy family was linked with better results.

Doug Johnson-Greene, PhD, MPH, associate professor, director of neuropsychology, and vice chair of rehabilitation medicine at the University of Miami Miller School of Medicine, says that the study gives very valuable information. The highlights of the study are the longer-follow up and the age of the children. Other studies did not have such a long follow up and very young children, he adds.

Thus the bottom-line of the research is that a head injury does not imply that it is forever. It provides evidence to the fact that impairments may not be persistent as believed. It also showed that the more severe the brain injury the tougher it is to repair. Parents can help children to recover by providing appropriate treatment. “A stimulating, healthy home environment is the best way to see a good recovery”, says Johnson-Greene.