Parent ratings of social-behavioral functioning after traumatic brain injury in very young children

Pediatric traumatic brain injury (TBI) can result in a myriad of negative outcomes, but little is known about the effects of early TBI on social-behavioral functioning. Using parent report on the Child Behavior Checklist (CBCL), the current study compared socialbehavioral outcomes of 3-year-olds who sustained a TBI prior to the age of 2 to a typicallydeveloping comparison group. The study addressed the following questions: 1) Do parent ratings of the social-behavioral functioning of preschoolers who sustained mild and moderate/severe TBI as very young children differ significantly from parent ratings of typically developing preschoolers? 2) Do groups of preschoolers with mild and moderate/severe TBI differ significantly from a group of typically-developing children in their observed incidence of behavioral problems based on parent ratings? 3) What child-, family-, and injury-related variables (e.g., developmental level, maternal education, injury severity) predict Internalizing, Externalizing and Total Problem scores on parent ratings of the CBCL in preschoolers after TBI? No group differences emerged between the Mild TBI (n=31), Moderate/Severe TBI (n = 20), and Typically-Developing (n = 31) Groups on the CBCL; group means were average. In exploratory analyses, the TBI Group as a whole did not differ from the Typically-Developing Group on the CBCL. When breaking apart the Moderate/Severe Group in exploratory analyses, the Moderate Group demonstrated a non-significant trend toward greater impairment in overall development, adaptive behavior, and social-behavioral functioning. Exploratory regression equations revealed Glasgow Coma Scale and the Self-Report Family Inventory Leadership scale as predictors of Externalizing Problems; overall developmental level significantly predicted Internalizing Problems. Findings suggest that as preschoolers, children who sustained TBI at a very early age do not differ significantly in their social-behavioral functioning from one another or a comparison group. It is premature to infer that preschoolers do not evidence socialbehavioral dysfunction after early TBI. Future research must use larger samples to develop models for identifying children who might evidence social-behavioral problems post injury. Longitudinal research is needed to assess whether the lack of findings at age three might be related to environmental and task demands that may emerge. Limitations and suggestions for future research are discusse

The nervous system and chronic kidney disease in children

This paper provides a review of the literature on the nervous system involvement incurred by children and adolescents with chronic kidney disease (CKD), with a particular focus on neuropsychological functioning. In addition to an historical overview of earlier literature, published studies from the past 14 years that address both central and peripheral nervous system function in children with CKD are reviewed (1990–2003). These studies span work in neuroimaging, electrophysiology, and neuropsychology. A key focus for this review is on variables that might affect neurodevelopmental status in these children. The paper concludes with suggestions for achieving progress in the understanding of this complication of kidney disease in children