Traumatic Brain Injury and the Very Young Child

*March is Brain Injury Awareness Month*

Traumatic brain injury (TBI) is the leading cause of disability and death in children and adolescents in the U.S. According to the Centers for Disease Control and Prevention, one of the two age groups at greatest risk for TBI includes infants and children ages 0-4. 
Among children ages 0 to 14 years, 

TBI results in an estimated:

• 2,685 deaths
• 37,000 hospitalizations
• 435,000 emergency department visits
• These can be frightening statistics for parents of children. And yet, through awareness and knowledge, we can change these numbers and lessen the impact on our loved ones.

Symptoms
Symptoms can result in physical, cognitive, communication and/or social/behavioral impairments, and may occur to different degrees. The nature of the injury and consequences can range from mild to severe, and the course of recovery is very difficult to predict for any given child. With early diagnosis and ongoing therapeutic intervention, the severity of these symptoms may decrease in varying degrees. Symptoms can vary greatly depending on the extent and location of the brain injury, and it may be years before the deficits from the injury become apparent.

What makes a brain injury in children different?
While the symptoms of a brain injury in children are similar to the symptoms experienced by adults, the functional impact can be very different. Children are not little adults. The brain of a child is continuing to develop. The assumption used to be a child with a brain injury would recover better than an adult because there was more “plasticity” in a younger brain.  More recent research has shown that this is not the case. A brain injury actually has a more devastating impact on a child than an injury of the same severity has on a mature adult. The cognitive impairments of children may not be immediately obvious after the injury but may become apparent as the child gets older and faces increased cognitive and social expectations for new learning and more complex, socially appropriate behavior. These delayed effects can create lifetime challenges for living and learning for children, their families, schools and communities. Some children may have lifelong physical challenges. However, the greatest challenges many children with brain injury face are changes in their abilities to think and learn and to develop socially appropriate behaviors.
  

Acute signs and symptoms of a concussion:

• Vomiting
• Headache
• Crying and inability to be consoled
• Restlessness or irritability

   

Prevention                                                                                                                                                          

To reduce the risk of an older child sustaining a TBI, parents/caregivers should assure that: 

• Everyone wears a seat belt each time they ride in a motor vehicle. (Children should continue to ride in a booster seat until the lap/shoulder belts in the car fit properly, typically when they are approximately 4’9" tall.)
• Children wear helmets that are fitted properly, and use the right protective equipment for sports and recreation, making sure it is maintained properly.

   

Living areas are made safe for children by:

• Keeping stairs clear of clutter;
• Securing rugs and using rubber mats in bathtubs; and
• Not allowing children to play on fire escapes or on other unsafe platforms.
• Confirming that playground surfaces are made of shock-absorbing materials, such as hardwood mulch or sand, and are maintained to an appropriate depth. 

Information taken from the Brain Injury Association of America; and Centers for Disease control and Prevention (Toolkit for Physicians)

Additional resources
MN Dept. of Education: http://www.education.state.mn.us/
MN Low Incidence Projects: http://www.mnlowincidenceprojects.org/tbi.html
Brain Injury Association of Minnesota: www.braininjurymn.org
Phone:  (612) 378-2742 (800) 669-6442
National Brain Injury Association of America: www.biausa.org
Phone:  (800) 444-6443
  

Department Of Health and Human Services, Centers for Disease Control and Prevention (CDC) www.cdc.gov/TraumaticBrainInjury/index.html  

For more information and resources, contact your district or regional TBI educational specialist; or: 

Barbara Sisco, State Low Incidence Specialist, MN Department of Education
Barbara.Sisco@state.mn.us

Deb Williamson, Statewide TBI Specialist, MN Low Incidence Projects
Deb.Williamson@metroecsu.org