Excerpts

Introduction

The Centers for Disease Control and Prevention (CDC) estimate that over a million children and adolescents are seriously injured and taken to hospitals for treatment annually. Among these children ages birth to 14 years, traumatic brain injury (TBI) results in a yearly estimated 2,685 deaths, 37,000 hospitalizations and 435,000 emergency visits. Even mild brain injuries or concussions can cause learning and behavior problems in children and youths. Unfortunately, brain injury is the largest killer and disabler of our children in the United States.

Some of our children and adolescents sustain “external physical force injury” to their brains from motor vehicle crashes, falls, abuse and sports injuries. Others sustain injuries to their brains from “internal occurrences” such as near drownings, infectious diseases (meningitis or encephalitis), strokes or aneurisms, brain tumors, and neurotoxic poisonings (lead, mercury, carbon monoxide). Any of these brain injuries can interrupt and change the development of a child’s brain.

The causes of brain injury vary by the child’s age. Infants and toddlers are often injured by falls, physical abuse, brain tumors, or strangulations. As children get older, they may sustain brain injuries in car crashes, bicycle-car crashes, pedestrian-car crashes, near drownings, or neurotoxic poisonings. Our teenagers are most likely to be injured by car crashes, sustain concussions in sports or recreational events, or by acts of violence (gun shots, assaults).

Brain injuries may cause a wide range of challenges for children and adolescents. They may have difficulties thinking and learning because of changes with attention, memory, speech, organization, processing speed, and planning. They may also have difficulty with behavior, knowing how to act socially, or how to make safe decisions. They may have problems with movement, walking, running, balance and sensory perception. All these problem areas may disrupt their success in school, at home and in the community.

Many children and adolescents are resilient enough to survive even severe trauma to their brains. However, they are vulnerable, or at risk, for long term effects from the injury to the brain. Since a child’s brain is a developing brain, it often takes longer for the effects of the injuries to be seen as the brain matures over time. We often hear that, “Time heals all wounds.” In brain injury among children, it may be just the opposite that, “Time reveals all wounds.”

Fortunately, doctors, neuroscientists and other brain injury experts are learning more and more about how the human brain works and develops. This information helps us know more about what happens after a child has a brain injury. By combining brain science with knowledge about brain injury, we can better understand what our children and adolescents need – today and in the future. This manual explains how the brain works from birth through adolescence and the effects of an injury on its development.