New research from the University of Warwick reveals that children with even mild head injury may be at risk of long-term complications, including personality changes, emotional, behavioural and learning problems.
The study published in the Journal of Neurology, Neurosurgery, and Psychiatry examined more than 500 children aged 5-15 years at head injury over a 6-year period. Parents were asked to register what changes they noticed in their child after the head injury, and what follow-up they had received from clinicians. Even after a mild head injury, one in five children had a change in personality according to their parents.
Parents often described the personality change after the head injury as “like having a different child”. Further, 43 percent of children with mild head injury had behavioural or learning problems that led to them being described as having a "moderate disability".
Overall around 30 percent of parents believed that their child’s personality had changed as a result of the initial damage. Among children with more serious head injuries, about two thirds had moderate disability, and about half experienced a major change in personality after the head injury.
Dr Carol Hawley, from Warwick Business School at the University of Warwick, said: “Many children with mild injury do not receive routine follow-up after discharge home from hospital, yet a significant proportion of them do have some lasting problems which may affect their behaviour and ability to learn. This could put them at a disadvantage at school.”
While all of the children in the study had been treated in a hospital after having a head injury, only 30 percent of parents said that doctors at the hospital had made a follow-up appointment for their child. In fact, 161 of the 252 children with moderate disability did not receive any follow-up care.
The study also suggests that there are there is inadequate provision for children with head injury, largely due to inadequate information. Teachers of only 40% of children were aware of the injury, and given the enduring nature of cognitive and behavioural problems following moderate or severe head injury, this is of concern.
Dr Carol Hawley continued: “It is likely that there are considerable numbers of children in the community, and back at school, who have suffered a head injury in the past and who might have subtle but important difficulties relating to that head injury.”
To help identify children suffering from the lingering effects of a head injury, a research team is now working on a questionnaire that physicians could send to parents after children with head injury are sent home from the hospital. Children found to be at risk of problems could be offered a follow-up assessment. If necessary, children could be referred to an appropriate health professional, such as an educational psychologist or community paediatrician.
For more information contact: Jenny Murray, Communications Office, University of Warwick, Tel: 02476 574 255, Mobile: 07876217740 or Dr Carol Hawley, Warwick Business School, University of Warwick, Tel: 02476 522459, Mobile: 07836 548152, Email: Carol.Hawley@wbs.ac.uk
Outcomes Following Childhood Head Injury: A Population Study is published in Journal of Neurology, Neurosurgery, and Psychiatry, May 2004