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A prospective study of children with head injuries: I. Design and methods

Published online by Cambridge University Press:  09 July 2009

Michael Rutter ,
Oliver Chadwick ,
David Shaffer  and
Gillian Brown
Oliver Chadwick
Affiliation:
Gertrude H. Sergievsky Center, College of Physicians and Surgeons of Columbia University, 630 West 168th Street, New York, NY 10032, USA.
David Shaffer
Affiliation:
Division of Child Psychiatry, College of Physicians and Surgeons of Columbia University, 722 West 168th Street, New York, NY 10032, USA.
Gillian Brown
Affiliation:
Bromley College of Technology, Rookery Lane, Bromley BR2 8HE.
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Synopsis

The main unresolved issues with respect to the psychological sequelae of brain damage in childhood are noted, and the previous studies of children suffering head injury are critically reviewed. A new prospective study is described. Three groups of children were studied: (a) 31 children with ‘severe’ head injuries resulting in a post-traumatic amnesia of at least 7 days; (b) an individually matched control group of 28 children with hospital-treated orthopaedic injuries; and (c) 29 children with ‘mild’ head injuries resulting in a post-traumatic amnesia exceeding 1 hour but less than 1 week. The children were studied as soon as possible after the accident and then again 4 months, 1 year, and 2¼ years after the injury. The parents were interviewed, using systematic and standardized interview techniques; both parents and teachers completed behavioural questionnaires; and the children were seen for individual psychological testing using the WISC, the Neale Analysis of Reading Ability and a battery of tests of more specific cognitive functions. At the final follow-up, the severe head injury group (but not the other 2 groups) received a systematic neurological examination and the school teacher who knew the child best was personally interviewed. The findings are given on physical handicap, neurological abnormality, school placement and psychiatric referrals. All types of disabilities were both more frequent and more persistent in the children with severe head injuries.

Type
Research Article
Information
Psychological Medicine , Volume 10 , Issue 4 , November 1980 , pp. 633 - 645
Copyright
Copyright © Cambridge University Press 1980

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References

REFERENCES

Backett, E. M. & Johnston, A. M. (1959). Social patterns of road accidents to children: some characteristics of vulnerable families. British Medical Journal i, 409–413.CrossRefGoogle Scholar
Becker, B. (1975). Intellectual change after closed head injury. Journal of Clinical Psychology 31, 307–309.3.0.CO;2-Y>CrossRefGoogle ScholarPubMed
Black, P., Jeffries, J., Blumer, D., Wellner, A. & Walker, A. E. (1969). The post-traumatic syndrome in children: characteristics and incidence. In The Late Effects of Head Injury (ed. Walker, A. E., Caveness, W. F. and Critchley, M.), pp. 142–149. Charles C. Thomas: Springfield, Ill.Google Scholar
Black, P., Blumer, D., Wellner, A. M. & Walker, A. E. (1971). The head-injured child: time-course of recovery, with implications for rehabilitation. In Head Injuries. Proceedings of an International Symposium held in Edinburgh and Madrid,2–10 April 1970, pp. 131–137. Williams & Wilkins: Baltimore.Google Scholar
Blau, A. (1936). Mental changes following head trauma in children. Archives of Neurology and Psychiatry 35, 723–769.CrossRefGoogle Scholar
Bond, M. R. (1975). Assessment of the psychosocial outcome after severe head injury. In Outcome of Severe Damage to the Central Nervous System. Ciba Foundation Symposium 34 (new series) (ed. Porter, R. and FitzSimons, D. W.), pp. 141–155. Excerpta Medica: Amsterdam.Google Scholar
Bowman, K. M., Blau, A. & Reich, R. (1974). Psychiatric states following head injury in adults and children. In Brock's Injuries of the Brain and Spinal Cord and Their Coverings (ed. Feiring, E. H.), pp. 570–613. Springer:New York.CrossRefGoogle Scholar
Brink, J. D., Garrett, A. L., Hale, W. R., Woo-Sam, J. & Nickel, V. C. (1970). Recovery of motor and intellectual function in children sustaining severe head injuries. Developmental Medicine and Child Neurology 12, 545–571.CrossRefGoogle ScholarPubMed
Brooks, D. N. (1976). Wechsler Memory Scale performance and its relationship to brain damage after severe closed head injury. Journal of Neurology, Neurosurgery and Psychiatry 39, 593–601.CrossRefGoogle ScholarPubMed
Brown, G. W. & Rutter, M. (1966). The assessment of family activities and relationships: a methodological study. Human Relations 19, 241–263.CrossRefGoogle Scholar
Brown, G., Chadwick, O., Shaffer, D., Rutter, M. & Traub, M. (1981). A prospective study of children with head injuries: III. Psychiatric sequelae. Psychological Medicine 11 (in the press).CrossRefGoogle ScholarPubMed
Burkinshaw, J. (1960). Head injuries in children: observations on their incidence and causes with an enquiry into the value of routine skull X-rays. Archives of Disease in Childhood 35, 205–214.CrossRefGoogle ScholarPubMed
Burton, L. (1968). Vulnerable Children. Schocken Books: New York.Google Scholar
Carlsson, C. A., Von Essen, C. & Löfgren, J. (1968). Factors affecting the clinical course of patients with severe head injury. Journal of Neurosurgery 29, 242–251.CrossRefGoogle Scholar
Chadwick, O., Thompson, J., Shaffer, D. & Rutter, M. (1980). Intellectual performance and reading ability after localized head injury in children. Journal of Child Psychology and Psychiatry (in the press).Google Scholar
Chadwick, O., Rutter, M., Brown, G., Shaffer, D. & Traub, M. (1981 a). A prospective study of children with head injuries: II. Cognitive sequelae. Psychological Medicine 11 (in the press).CrossRefGoogle ScholarPubMed
Chadwick, O., Rutter, M., Shaffer, D. & Shrout, P. (1981 b). A prospective study of children with head injuries: IV, Specific cognitive defects, (Submitted for publication.)CrossRefGoogle Scholar
Conners, C. (1973). Rating scales for use in drug studies in children. In Pharmacotherapy of Children, pp. 24–84. Psychopharmacology Bulletin, Special Suppl. to Vol. 9.Google Scholar
Craft, A. W., Shaw, D. A. & Cartlidge, N. E. (1972). Head injuries in children. British Medical Journal iii, 200–203.CrossRefGoogle Scholar
Dillon, H. & Leopold, R. C. (1961). Children and the postconcussion syndrome. Journal of the American Medical Association 175, 86–92.CrossRefGoogle Scholar
Early Clinical Drug Evaluation Unit (ECDEU) (1976). Assessment Manual. US National Institute of Mental Health, Psychopharmacology Research Branch: Rockville, Md.Google Scholar
Fabian, A. A. (1956). Prognosis in head injuries in children. Journal of Nervous and Mental Disease 123, 428–431.CrossRefGoogle ScholarPubMed
Fahy, T. J., Irving, M. H. & Millac, P. (1967). Severe head injury. Lancet ii, 475–479.CrossRefGoogle Scholar
Field, J. H. (1976). Epidemiology of Head Injuries in England and Wales. HMSO: London.Google Scholar
Graham, P. & Rutter, M. (1968). The reliability and validity of the psychiatric assessment of the child. II. Interview with the parent. British Journal of Psychiatry 114, 581–592.CrossRefGoogle ScholarPubMed
Harrington, J. A. & Letemendia, F. J. J. (1958). Persistent psychiatric disorders after head injuries in children. Journal of Mental Science 104, 1205–1218.CrossRefGoogle ScholarPubMed
Harris, P. (1957). Head injuries in childhood. Archives of Disease in Children 32, 488–491.CrossRefGoogle ScholarPubMed
Heiskanen, D. & Kaste, M. (1974). Late prognosis of severe brain injury in children. Developmental Medicine and Child Neurology 16, 11–14.CrossRefGoogle ScholarPubMed
Hjern, B. & Nylander, I. (1964). Acute head injuries in children: traumatology, therapy and prognosis. Acta paediatrica scandinavica Suppl. 152.CrossRefGoogle Scholar
Jennett, B. (1975). Scale, scope and philosophy of the clinical problem. In Outcome of Severe Damage to the Central Nervous System. Ciba Foundation Symposium 34 (new series) (ed. Porter, R. and FitzSimons, D. W.), pp. 3–9. Excerpta Medica: Amsterdam.Google ScholarPubMed
Jennett, B. (1976). Assessment of severity of head injury. Journal of Neurology, Neurosurgery and Psychiatry 39, 647–655.CrossRefGoogle ScholarPubMed
Jennett, B., Teasdale, G., Galbraith, S., Pickard, J., Grant, H., Braakman, R., Avezaat, C., Maas, A., Minderhoud, J., Vecht, C. J., Heiden, J., Small, R., Caton, W. & Kurze, T. (1977). Severe head injuries in three countries. Journal of Neurology, Neurosurgery and Psychiatry 40, 291–298.CrossRefGoogle ScholarPubMed
Kalveboer, A. F., Van Praag, H. M. & Mendelwicz, J. (eds.) (1978). Minimal brain dysfunction: fact or fiction. In Advances in Biological Psychiatry Vol. 1, pp. 5–17. S. Karger: Basel.Google Scholar
Klonoff, H. & Paris, R. (1974). Immediate short-term and residual effects of acute head injuries in children: neuropsychological and neurological correlates. In Current Status and Applications (ed. Reitan, R. M. and Davison, L. A.), pp. 179–210. Halstead Press: New York.Google Scholar
Klonoff, H., Low, M. D. & Clark, C. (1977). Head injuries in children: a prospective five year follow-up. Journal of Neurology, Neurosurgery and Psychiatry 40, 1211–1219.CrossRefGoogle ScholarPubMed
Lecuire, J., Dechaume, J. P. & Deruty, R. (1971). Long term prognosis of the prolonged and serious traumatic comas. In Head Injuries. Proceedings of an International Symposium held in Edinburgh and Madrid,2–10 April 1970, pp. 141–144. Williams & Wilkins: Baltimore.Google Scholar
Levin, H. S. & Eisenberg, H. M. (1979). Neuropsychological outcome of closed head injury in children and adolescents. Child's Brain 5, 281–292.Google ScholarPubMed
Lishman, W. A. (1978). Organic Psychiatry. Blackwell Scientific: Oxford.Google Scholar
Mandleberg, I. A. & Brooks, D. M. (1975). Cognitive recovery after severe head injury. 1. Serial testing on the Wechsler Adult Intelligence Scale. Journal of Neurology, Neurosurgery and Psychiatry 38, 1121–1126.CrossRefGoogle ScholarPubMed
Manheimer, D. I. & Mellinger, G. D. (1967). Personality characteristics of the child accident repeater. Child Development 38, 491–513.CrossRefGoogle ScholarPubMed
Neale, M. D. (1958). Neale Analysis of Reading Ability (Manual). Macmillan: London.Google Scholar
Oddy, M., Humphrey, M. & Uttley, D. (1978). Subjective impairment and social recovery after closed head injury. Journal of Neurology, Neurosurgery and Psychiatry 41, 611–616.CrossRefGoogle ScholarPubMed
Otto, U. (1960). The post-concussion syndrome in children. Acta paedopsychiatrica 27, 6–20.Google ScholarPubMed
Partington, M. W. (1960). The importance of accident- proneness in the aetiology of head injuries in childhood. Archives of Disease in Childhood 35, 215–223.CrossRefGoogle ScholarPubMed
Quinton, D., Rutter, M. & Rowlands, O. (1976). An evaluation of an interview assessment of marriage. Psychological Medicine 6, 577–586.CrossRefGoogle ScholarPubMed
Richardson, F. (1963). Some effects of severe head injury:a follow-up study of children and adolescents after protracted coma. Developmental Medicine and Child Neurology 5, 471–482.CrossRefGoogle Scholar
Rowbotham, G. F., Macinver, I. N., Dickson, J. & Bousfield, N. E. (1954). Analysis of 1400 cases of acute injury to the head. British Medical Journal i, 726–730.CrossRefGoogle Scholar
Rune, V. (1970). Acute head injuries in' children. Acta paediatrica scandinavica Suppl. 209.Google Scholar
Russell, W. K. (1971). The Traumatic Amnesias. Oxford Neurological Monographs. Oxford University Press: London.Google Scholar
Russell, W. R. & Smith, A. L. (1961). Post-traumatic amnesia in closed head injury. Archives of Neurology 5, 16–29.CrossRefGoogle ScholarPubMed
Rutter, M. (1967). A children's behaviour questionnaire for completion by teachers: preliminary findings. Journal of Child Psychology and Psychiatry 8, 1–11.CrossRefGoogle ScholarPubMed
Rutter, M. (1977). Brain damage syndromes in childhood:concepts and findings. Journal of Child Psychology and Psychiatry 18, 1–21.CrossRefGoogle Scholar
Rutter, M. (1980). Raised lead levels and impaired cognitive/ behavioral functioning: a review of the evidence. Developmental Medicine and Child Neurology 22, Suppl. 42.Google Scholar
Rutter, M. & Brown, G. W. (1966). The reliability and validity of measures of family life and relationships in families containing a psychiatric patient. Social Psychiatry 1, 38–53.CrossRefGoogle Scholar
Rutter, M. & Chadwick, O. P. D. (1980). Neuro-behavioral associations and syndromes of ‘minimal brain dysfunction’. In Clinical Neuro-Epidemiology (ed. Rose, F. C.), pp. 330–338. Pitman: London.Google Scholar
Rutter, M. & Cox, A. D. C. (1978). The Assessment of Diagnostic Interviewing Techniques in Child Psychiatry. Final Report to the SSRC.Google Scholar
Rutter, M., Graham, P. & Yule, W. (1970). A Neuropsychiatric Study in Childhood. Clinics in Developmental Medicine Nos. 35/36. SIMP/Heinemann Medical: London.Google Scholar
Rutter, M., Cox, A., Tupling, C., Berger, M. & Yule, W. (1975). Attainment and adjustment in two geographical areas. I. The prevalence of psychiatric disorder. British Journal of Psychiatry 126, 493–509.CrossRefGoogle Scholar
Seidel, U., Chadwick, O. & Rutter, M. (1975). Psychological disorders in crippled children. A comparative study of children with and without brain damage. Developmental Medicine and Child Neurology 17, 563–573.CrossRefGoogle ScholarPubMed
Shaffer, D., Chadwick, O. & Rutter, M. (1975). Psychiatric outcome of localized head injury in children. In Outcome of Severe Damage to the Central Nervous System. Ciba Foundation Symposium 34 (new series) (ed. Porter, R. and FitzSimons, D. W.), pp. 191–213. Exccrpta Medica: Amsterdam.Google Scholar
Stover, S. L. & Zeiger, H. E. (1976). Head injury in children and teenagers: functional recovery correlated with the duration of coma. Archives of Physical Medicine and Rehabilitation 57, 201–205.Google ScholarPubMed
Strecker, E. A. & Ebaugh, F. G. (1924). Neuropsychiatric sequelae of cerebral trauma in children. Archives of Neurology and Psychiatry 12, 443–453.CrossRefGoogle Scholar
Swinyard, C. A., Swansen, J. & Greenspan, L. (1963). An institutional survey of 143 cases of acquired cerebral palsy. Developmental Medicine and Child Neurology 6, 615.CrossRefGoogle Scholar
Wechsler, D. (1949). Wechsler Intelligence Scale for Children (Manual). Psychological Corporation: New York.Google Scholar