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Objective: The prevalence of mild traumatic brain injury (mTBI) in preschoolers (0-5 years) is high and its effects are understudied. Childhood is an important time for brain and functional development and acquiring a brain insult during this period could be detrimental. Studies conducted to date indicate that early TBI may have adverse cognitive, behavioral and social consequences. One study by our group found that preschool children with mTBI had poorer performance on theory of mind (ToM) tasks 6-months post-injury compared to children with orthopedic injuries (OI) and to typically developing children (TDC), suggesting a brain-injury-specific effect. These differences were found to persist up to 18 months post-injury and to correlate with social competence. The objectives of the current analyses were to establish if differences in ToM persist at 30 months post-injury and if reduced ToM is associated with changes in global social competence.Methods: Children with mTBI and OI between 18 and 60 months of age were recruited at the emergency department of a tertiary care pediatric hospital and were followed-up at 6-, 18- and 30-months post-injury. 64 children (mean (M) age= 69.6, SD= 11.2 months, 26 boys) with mTBI participated in the 30-month follow-up and their performance was compared to 38 children with OI (M age=65.4, SD=11.7 months, 15 boys) and 56 children (M age=68.3, SD=11.7 months, 29 boys) recruited from the community (TDC). At 30 months post-injury they completed a battery of cognitive and social tasks including measures of ToM: False Belief Stories and Content to Self and to Others. Their parents completed the Social subscale of the Adaptive Behavior Assessment System (ABAS Social) as an indicator of social competence. Results: The mTBI group did not significantly differ from the OI or TDC groups on any of the ToM tasks: False Belief Stories: F(2,146)= 1,05, p= .35, Content to Self: F(2,140)= 2,12, p=.13; Content to Others: F(2,138)= 0,92, p= .40. Hierarchical regression analysis indicated that sex, SES and age significantly contributed to global social competence at 30 months post-injury (F(1,55) =9.94, p=.0001), but the inclusion of ToM abilities did not explain any additional variance in social competence at 30 months post-injury (F change (1,54)= .11, p=.74). Conclusion: The findings indicate that post-mTBI differences in ToM that were present at 6- and 18-months post-injury resolved at 30 months post-injury. The data suggest that it may take up to 30 months for young children who sustain mTBI to return to typical age-related levels of social cognition, as measured by ToM. Encouragingly, reduced social cognition (ToM) observed in the first year and a half post-injury does not seem to affect social competence in the very long term.
Traumatic brain injury (TBI) remains a significant source of death and permanent disability, contributing to nearly one-third of all injury related deaths in the United States and exacting a profound personal and economic toll. Despite the increased resources that have recently been brought to bear to improve our understanding of TBI, the developme
With the contribution from more than one hundred CNS neurotrauma experts, this book provides a comprehensive and up-to-date account on the latest developments in the area of neurotrauma including biomarker studies, experimental models, diagnostic methods, and neurotherapeutic intervention strategies in brain injury research. It discusses neurotrauma mechanisms, biomarker discovery, and neurocognitive and neurobehavioral deficits. Also included are medical interventions and recent neurotherapeutics used in the area of brain injury that have been translated to the area of rehabilitation research. In addition, a section is devoted to models of milder CNS injury, including sports injuries.
Progress in research on traumatic brain injury is presented in this book encompassing translational and clinical investigations. Observational and interventional studies are discussed by leading investigators of TBI in adults and children. Contributors from various countries provide a global perspective on this worldwide health problem.
In the past decade, few subjects at the intersection of medicine and sports have generated as much public interest as sports-related concussions - especially among youth. Despite growing awareness of sports-related concussions and campaigns to educate athletes, coaches, physicians, and parents of young athletes about concussion recognition and management, confusion and controversy persist in many areas. Currently, diagnosis is based primarily on the symptoms reported by the individual rather than on objective diagnostic markers, and there is little empirical evidence for the optimal degree and duration of physical rest needed to promote recovery or the best timing and approach for returning to full physical activity. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture reviews the science of sports-related concussions in youth from elementary school through young adulthood, as well as in military personnel and their dependents. This report recommends actions that can be taken by a range of audiences - including research funding agencies, legislatures, state and school superintendents and athletic directors, military organizations, and equipment manufacturers, as well as youth who participate in sports and their parents - to improve what is known about concussions and to reduce their occurrence. Sports-Related Concussions in Youth finds that while some studies provide useful information, much remains unknown about the extent of concussions in youth; how to diagnose, manage, and prevent concussions; and the short- and long-term consequences of concussions as well as repetitive head impacts that do not result in concussion symptoms. The culture of sports negatively influences athletes' self-reporting of concussion symptoms and their adherence to return-to-play guidance. Athletes, their teammates, and, in some cases, coaches and parents may not fully appreciate the health threats posed by concussions. Similarly, military recruits are immersed in a culture that includes devotion to duty and service before self, and the critical nature of concussions may often go unheeded. According to Sports-Related Concussions in Youth, if the youth sports community can adopt the belief that concussions are serious injuries and emphasize care for players with concussions until they are fully recovered, then the culture in which these athletes perform and compete will become much safer. Improving understanding of the extent, causes, effects, and prevention of sports-related concussions is vitally important for the health and well-being of youth athletes. The findings and recommendations in this report set a direction for research to reach this goal.
Describes multidisciplinary, integrative, and translational approaches to research and practice in pediatric traumatic brain injury.
The Veterans Benefits Administration (VBA) provides disability compensation to veterans with a service-connected injury, and to receive disability compensation from the Department of Veterans Affairs (VA), a veteran must submit a claim or have a claim submitted on his or her behalf. Evaluation of the Disability Determination Process for Traumatic Brain Injury in Veterans reviews the process by which the VA assesses impairments resulting from traumatic brain injury for purposes of awarding disability compensation. This report also provides recommendations for legislative or administrative action for improving the adjudication of veterans' claims seeking entitlement to compensation for all impairments arising from a traumatic brain injury.