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Traumatic Brain Injury in Children
Traumatic brain injury (TBI) isn’t an injury that solely affects adults. It can also occur in babies, toddlers, children, and teens, and can be harmful to a child’s developing brain. Children are not simply small adults, and traumatic brain injury (TBI) in children must be treated with special care.
What is a TBI?
Traumatic Brain Injury (TBI) is an injury to the brain that occurs as a result of a blow or jolt to the head, neck, or body. TBIs can range in severity from mild, to moderate or severe. The least severe form of TBI is mild TBI, also known as concussion. Paediatric TBI is a term used to refer to TBI that occurs in children and adolescents.
Common causes of TBI in children and teens
Young children regularly knock their heads as they are learning to navigate the world – crawling, walking, and becoming coordinated all have their challenges. The most common cause of TBI in children under 5 years of age are falls – be it falling off the bed, falling over as they are learning to stand and walk, falling from a bike, play equipment, or climbing frame.
Other common causes of TBI amongst older children and teens include motor vehicle crashes and sports and recreational activities. Both contact (e.g. AFL, rugby, soccer) and non-contact sports (e.g., gymnastics, swimming, horse riding) can result in concussion. To learn more about Sports-Related Concussion, check out our free online short course here.
Signs and symptoms of TBI in children
TBI can result in a range of signs (things we can see) and symptoms (things people tell us that they are experiencing). Each TBI is unique, and signs of symptoms of TBI can vary from person to person. TBI signs and symptoms may present immediately after the injury has occurred, or they may develop in the hours or days that follow.
Spotting a TBI in infants and toddlers can be difficult as they may lack the communication or developmental skills to express how they are feeling. As such, it’s important that parents/carers and clinicians be aware of the following changes that may appear initially after injury and indicate a TBI has occurred in this age group.
– Loss of consciousness or deteriorating conscious state
– Seizures or convulsions
– Changes in the ability to pay attention
– Change in nursing or eating habits
– Change in sleeping habits
– Changes in play (e.g. loss of interest in favourite toys/activities)
– Irritability, persistent crying, or inability to be consoled
– Sensitivity to light and/or noise
– Lethargy/increased fatigue
– Altered level of alertness or hard to awaken
– Loss of acquired language
– Loss of new skills, such as toilet training
– Unsteady walking, loss of balance
– Vomiting
– Continual bleeding or fluid discharge from ear or nose
Injuries that indicate physical trauma, such as scalp swelling, bruises or skin tears on the head, neck, or body, should also be looked out for. Older children and teens are likely to experience TBI signs and symptoms similar those reported by and seen in adults. For more information, see our webpages on What is a TBI and TBI symptoms explained.
Complications and consequences of TBI
TBI can have a wide-ranging physical and psychological effects. These include altered states of consciousness, physical complications, changes in behaviour, emotion, and cognitive skills and abilities as well as communication and sensory problems. Some complications/consequences are apparent immediately after a TBI has occurred while others may develop over time. What complications/consequences arise following a TBI largely depend on the brain areas that are affected and to what degree. Each TBI is unique, and no two children/teens will experience the same complications or consequences. Some TBI complications/consequences are irreversible, while others may be treated or managed with the help of medical specialists and allied health professionals. You can read more about TBI symptoms here.
Long-term consequences of TBI in children and teens
Though children and teens can experience many of the same consequences of TBI as adults, the functional impact of these consequences may be far greater. Children are not simply small adults. Children’s brains are still developing, with some parts of the brain not reaching full maturity until mid-to-late 20s.
It was once believed that children would recover from TBI better than adults because of the greater “plasticity” of younger brains, though recent research indicates that this may not be the case. A TBI can indeed have devastating impacts on children’s and teen’s physical and neuropsychological development and overall quality of life. The extent of these impacts can be influenced by a range of factors, including the age at which the TBI occurred and the severity of the TBI, with more favourable outcomes generally being expected for children with mild TBI (concussion) relative to those with moderate/severe TBI.
Family Environment
Family environment has also been found to influence outcome following paediatric TBI, and is an important factor to consider given that paediatric TBI itself can have significant impacts on family life. Accessing medical and social support services can help manage some of the challenges faced by affected individuals and their families.
Paediatric Development
The consequences of TBI can affect various facets of children and teen’s lives, including their ability to learn, make and keep up friendships, and participate in home, school, and community activities. Though more research into the long-term effects of TBI is required, especially for infants and toddlers, the existing research indicates that recovery from paediatric TBI is unique to the individual and can take many forms.
Some young children with TBI may demonstrate a relatively typical developmental progression in the initial stages of recovery, while others may continue to experience long-term difficulty with learning new information and navigating more complex social interactions due to impairments in cognitive function. In some cases, the effects of TBI are not immediately present following injury, with children experiencing challenges later in their development, particularly as academic demands increase.
The consequences of paediatric TBI can co-occur with other existing developmental conditions such as attention-deficit/hyperactivity disorder, autism spectrum disorder, learning disabilities, intellectual disability, and other language and communication disorders. Furthermore, the full sequelae of paediatric TBI can also emerge and/or persist well into adulthood lending to the perspective that TBI is a chronic disease process rather than a one-time event.
To further help you, we have a range of children’s TBI fact sheets here.
Acknowledgements
This article contains information adapted from American Speech-Language-Hearing Association.
Disclaimer: If you think your child has suffered a TBI it’s important to have them seen by a medical professional as soon as possible. Connectivity does not offer medical advice for individuals.
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References
Article updated August 2023