Mild traumatic brain injury represents the most common form of TBI in children, adolescents or young adults. Yet, we tend to dismiss mild brain injury or concussion in young people as of little consequence, at least over the long term.
Are you worried about a child, adolescent or young adult you know, or work with, who has suffered a mild brain injury or concussion? Have you been told, or do you believe, that there is nothing to worry about, that the effects of a mild traumatic brain injury or concussion are likely to be relatively benign and short lived?
Generally this is true, but research indicates that there are still numerous children, adolescents or young people who follow an atypical course, and go on to suffer long term detrimental effects following a mTBI or concussion. These often show up as neurocognitive impairments, such as memory, attention, processing speed and executive control problems.
Cognitive impairments like these are often at issue in the persistent academic difficulties that some of these children will exhibit following a concussion or mild TBI.
As a result of your concern did you obtain an MRI or other brain scan for the child? Were the results normal? If so, this does not mean a brain injury did not occur. Brain imagery techniques are not always sensitive enough to reveal a brain injury, or the varying types and degrees they can take.
In addition, our knowledge of mild traumatic brain injury in children and adolescents is limited. We know far more about moderate to severe brain injuries in children,
than we do about mTBI or concussion in children. We also know
considerably more about the effects of mild traumatic brain injury in
adults, than we do about the effects of mild brain injury in children
However, we are learning that the effects of a brain injury in children, are likely to be different than in adults, and as some research suggests more detrimental and long lasting. This is the result of the developing nature of the immature brain. This applies to mild brain injury or concussion, as well as moderate and severe traumatic brain injuries.
The child you are worried about may well be one of the numerous children who do not show the same positive recovery, following a mTBI, as most children do. Instead they show persistent long-term negative effects.
If so you are likely discouraged and unsure of how to help.
You may also be unsure of whether these children require any treatment at all, other than close monitoring during the acute post injury stage. Even if you feel more is needed, you may be unsure of how to evaluate and treat these children.
The child or adolescent may be showing showing difficulties in specific areas of functioning, that were not evident prior to the mTBI, and/or to the same degree as they were, after its occurrence. These might include problems learning at school, or memory problems, or other neurocognitive concerns. Or perhaps the child is showing social/emotional and/or behavioral concerns.
The child seems different since he suffered the injury. He struggles in areas he never struggled in before, especially at school. And these concerns have persisted beyond the expected time line.
Even with the passage of time the child is showing limited improvement, and in some cases his condition may be worsening.
No two brain injuries are alike, and multiple risk factors will contribute to the course a mild TBI or concussion will take in each individual case. Most children will move on after a mild Traumatic Brain Injury, with no lasting ill effect. But some will continue to struggle, long after the injury took place, and show no signs of moving toward pre-injury functioning.
How can we help these children? How can we get to the "root of the problem" and find out what is holding the child back, despite what appears a mild TBI or concussion? And what can we do to help the child move forward toward improved functioning and well being?
Dr. O'Connor, a Toronto Psychologist, can help.
She provides school neuropsychological testing for children, adolescents and young adults. The school neuropsychological evaluation explores the child's functioning across the following neuropsychological domains:
Social and emotional functioning is also addressed, as are the child's academic skill levels and his General Intellectual Ability.
School neuropsychological evaluations explore the neuropsychological weaknesses and strengths the child exhibits, and their nature and extent. Following the assessment, a comprehensive written report is provided.
This report outlines the assessment findings, and describes the specific neuro-cognitive concerns the child exhibits, including their nature and extent. The child's strengths are also explored, and used, when appropriate, to help the child compensate for the challenges he/she faces. The report also includes evidence based interventions to help promote positive outcomes in the child, despite the challenges he currently faces, as the result of a mild TBI or concussion.
The school neuropsychological evaluation can assist when the child has suffered a mild TBI or concussion, and is showing limited signs of recovery. School neuropsychological testing quantifies the severity of the child's impairments and provides objective, valid and reliable measures of cognition, emotions, personality and behavior. These results can also help inform an effective treatment program.
Click here, to learn more about a how a School Neuropsychological Evaluation can help when a child or adolescent suffers from a mild TBI or concussion.