A child or adolescent can suffer a mild, moderate or even a severe traumatic brain injury (TBI) from numerous activities in their everyday lives. Some common causes for children include bicycle accidents, motor vehicle collisions, accidents in recreational sports and even accidents on playground equipment.
Given these common causes, it should come as no surprise that children and adolescents are some of the most at risk populations for sustaining a TBI. In fact, children under the age of 15 have a 1 in 5 chance of sustaining some form of TBI, and over 3% of hospital admissions are attributed to TBI alone. Children under the age of 5 are at an even greater risk due to their higher propensity for falls.
A TBI during any stage of childhood or adolescence presents unique challenges that must be addressed by qualified healthcare providers as early as possible and monitored closely in the months and years following the trauma.
The human brain is in a developmental stage until a person is well into their twenties. There is a common belief in the medical community that children and adolescents are better suited to make a substantial recovery following a TBI due to the natural changes that are occurring in their developing brains.
However, some research has been critical of this prevailing view and it has been noted that a TBI at an early stage in life results in a multitude of processes being disrupted. While the developing brain may be more malleable, this malleability does not apply to all areas of function.
More importantly, the effect of a TBI is influenced by the type of injury sustained, the location of the injury on the brain, the injury’s severity and the age of the individual at the time of injury. Because the symptoms that result from a TBI can be so unpredictable and sometimes not fully appreciated by parents, challenges often present themselves during treatment, making early intervention all the more important.
The challenges with treating a TBI that has occurred at an early stage in a person’s life is perhaps most apparent for children aged 6 years and under. Unlike their older school-aged counterparts, there is often no objective information regarding how the young child functioned prior to the injury. At the same time, many young children are just learning to use their verbal communications skills, making it difficult to assess the severity of the injury and impeding the ability to predict any ongoing symptoms and problems.
There is a danger that without the early intervention of a qualified medical and rehabilitation team, many of the symptoms related to the TBI may be overlooked or credited to be “normal” childlike behaviour. It is important to be aware of the more latent symptoms of TBI (e.g. fatigue, unexplained aggression, and withdrawal) and ensure that they are addressed as early as possible.
While parental observation can provide some information on how the child functioned before the injury, it is essential to have them assessed by a qualified medical professional with experience in paediatric brain injuries as early as possible. An assessment at an early stage, along with progress monitoring, will provide a greater chance of separating the symptoms of the TBI from those normal, child-like behaviours. This will ultimately provide a more objective baseline of measuring the child’s recovery.