Traumatic brain injury (TBI) is relatively common among children and adolescents.  Although most injuries are mild, children may acquire new neurological or cognitive disabilities as a result of these injuries.  Many children may return to school after mild TBIs without support or rehabilitation.  It used to be thought that children made especially good recoveries after a traumatic brain injury because of the plasticity of the young brain.  But current research suggests that until adulthood, the young brain is in fact particularly vulnerable to injury.  This study, based in Britain, assessed the support students received in school after a TBI and the educational and intellectual performance and school difficulties experienced after TBI. 

In one hospital, all children between ages 5-15 who had been admitted for a traumatic brain injury were eligible for the study.  Parents of 139 children completed a questionnaire.  Severity of the TBI was determined using the Glasgow Coma Scale and history of duration of loss of consciousness.  Questionnaires were also sent to the school, with a request that the teacher who best knew the child should respond.   The population consisted of 35 children with mild TBI, 13 with moderate and 19 with severe TBIs.  Fourteen uninjured children were chosen as matched controls.   
One-third of teachers were unaware their student had a TBI.  Two-third of students with a TBI had educational difficulties, half had attention/concentration problems and 39% had memory problems.   Half of the TBI group had a reading age that was greater than one year below their chronological age, and one-third were reading more than 2 years below their chronological age.  The authors advised doctors to notify schools that a child had a TBI and not to rely solely on parents sharing this information.  

(Hawley CA et al.  Arch Diseases of Childhood 2004; 89:136-142.) 

Comment:  This was a British study and one wonders if in the USA, more children with a TBI are brought to the attention of the school.  Perhaps because of the specific special education category for theses children, the statistics are better in the USA.  But given that most kids in this study had very mild TBI, it is possible that even in the USA, these mild TBI sufferers are at school, having educational problems, and school staff are never informed as to the reason.   – H.T.