Introduction

Traumatic brain injury (TBI) is one of the most common causes of acquired disability during childhood. While the majority of such injuries are mild, and result in few, if any, functional sequelae, children sustaining more significant insults may experience permanent cognitive and behavioral deficits. Clinical reports indicate residual impairments in a range of skills, particularly information-processing, attention, memory, learning, social function and behavior. These deficits impact on a child's capacity to interact with the environment effectively, resulting in lags in skill acquisition, and increasing gaps between injured children and their age peers, as they move through childhood and into adulthood. Secondary deficits may also emerge, relating to family stress and adjustment difficulties. Treatment and management of the child with TBI and family requires long-term involvement, where the role of the neuropsychologist is to understand the child's difficulties, to inform parents and the wider community of their cognitive and behavioral implications, to liaise with teachers and rehabilitation workers, to design academic and vocational interventions and behavior-management programs, and to provide counseling with respect to adjustment issues for the child and family.

Epidemiology

Population-based studies have recently reported that 750:100,000 children will suffer TBI each year. Of these, fewer than half will seek medical care, 10% will be hospitalized and only 7% will sustain significant head injury [1]. Between 5 and 10% will experience temporary and/or permanent neuropsychological impairment, and 5 to 10% will sustain fatal injuries [2].