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Behavioral Outcomes After Pediatric Closed Head Injury: Relationships With Age, Severity, and Lesion Size

Department of Pediatrics and Neurosurgery, University of Texas Medical SchoolHouston, Houston, TX

Harvey S. Levin, PhD

Division of Neurosurgery, University of Maryland Medical Systems, Baltimore, MD

David Lachar, PhD

Department of Psychiatry and Behavioral Sciences, University of Texas Medical School-Houston, Houston, TX

Lori Kusnerik

Department of Surgery, University of Texas Medical Branch, Galveston, TX

Harriet Harward, MA

Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX

Dianne Mendelsohn, MD

Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX

Matthew A. Lilly, MA

Division of Neurosurgery, University of Maryland Medical Systems, Baltimore, MD

This study investigated the behavioral outcomes and adaptive functioning of 138 children with mild to severe closed head injury in the 6- to 16-year age range. Each child was evaluated with the Personality Inventory for Children-Revised. A subset of this sample (n = 77) received the Vineland Adaptive Behavior Scales. Results revealed little evidence for group differences based on severity of closed head injury on scales associated with psychopathology on the Personality Inventory for Children-Revised. However, children with severe closed head injury were viewed as experiencing more difficulties than children with mild-moderate closed head injury on those components of the Personality Inventory for Children-Revised most closely associated with cognitive functions. In addition, on the Vineland Adaptive Behavior Scales, severely injured children had lower scores on the Communication and Socialization scales than children with mild-moderate injury. Relationships between the size of frontal and extrafrontal lesions from concurrent magnetic resonance imaging and behavioral outcomes were not apparent. This study suggests that outcome measures assessing adaptive behavior and cognitive functions are more sensitive to severity of closed head injury than parent-based scales of internalizing and externalizing psychopathology. (J Child Neurol 1996; 11: 283-290).

Journal of Child Neurology, Vol. 11, No. 4, 283-290 (1996)
DOI: 10.1177/088307389601100404


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