Effects of childhood head injuries may surface later Evidence shows problems with learning, language take years to show up

February 10, 1996|By Douglas Birch | Douglas Birch,SUN STAFF

Researchers once thought that many children who suffered severe head injuries could bounce back, regaining lost ground as their brains matured. But there is mounting evidence that such injuries can derail mental development, causing learning and language problems that may not show up until years later.

Children who suffer head injuries when they are 5 or 6 might not show serious difficulties until they are 8 or 10 ten years old, said Sandra Bond Chapman, a brain researcher speaking at the 1996 meeting of the American Association for the Advancement of Science in Baltimore. Then, she said, they may suddenly struggle with complex sentences, have problems reasoning or remembering, or become aggressive.

"These children can't keep up; they have to recover again and again," said Dr. Chapman, who works at the University of Texas in Dallas.

Head injuries are the leading cause of death among children, she said, and one in 30 newborns can expect to suffer a severe head injury before the age of 16. Yet there are few long-term studies of the impact of these devastating injuries on children, she said.

Dr. Chapman and other scientists at the University of Texas are in the fifth year of a seven-year investigation of brain-injured children. So far, they have evaluated about 250 children admitted to hospitals in several Texas cities, mostly as the result of auto accidents. (For a time, the University of Maryland Medical Center in Baltimore also took part.)

What Dr. Chapman and her colleagues have found is that the younger the child at the time of the injury, the harder it is for him or her to develop normal language and reasoning abilities. Children with injuries to the front of the brain -- the area most likely to be injured in an auto accident -- struggle harder than those suffering injuries elsewhere.

Long-term language problems show up in about three-quarters of children with moderate to severe brain injuries.

"I think what surprised us is the number of kids at age 8 to 10 that were having some of these deficits," Dr. Chapman said.

Children with head injuries also often baffle teachers, who may misinterpret on-again, off-again symptoms as defiance. "In the classroom, it's one day they can do it; another day they can't," Dr. Chapman said.

Often these children don't fit into special education courses, because their disabilities are restricted to specific tasks. "They still have normal areas," she said.

pTC Yet they can't learn in regular classrooms, either. "They have no place to go," she said, unless the school can offer custom-designed instruction.

In the next year, Dr. Chapman said, she and her colleagues will begin studying whether intensive intellectual stimulation can help these children develop normally. Some animal and human studies have shown that doing challenging tasks can increase the flow of blood to the brains of head trauma victims.

There is also hope that new drugs can help reduce the injuries inflicted by a cascade of chemical changes that occur in the brain immediately after a blow to the head.

Dr. Chapman advised the parents of such children to work with a speech and language pathologist in developing an educational strategy. And, she said, parents should seek allies, such as the local head injury association, in their efforts to get the child the help he or she may need.

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