We report on the effects of etiology and age on the linguistic outcomes in a large pediatric hemispherectomy population. Four populations were considered separately: cortical dysplasia (multilobar involvement), Rasmussen’s encephalitis, infarction as a primary etiology and, fourth, children who failed to develop language, regardless of etiology. We argue against the ‘the-earlier-thebetter’ hypothesis and propose our own hypothesis that weds maturational factors to etiological factors to predict language outcomes following pervasive brain insult. The implications of our ‘critical impact point ’ hypothesis are discussed
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