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 Attention problems have been seen in adults after TBI. This study,
however, is the first to show not just lapses of attention in
children with TBI but also that these lapses are related to
intelligence and attention problems, said lead author Marsh Konigs
of VU University Amsterdam in The Netherlands.
His team compared 113 kids, ages six to 13, who had suffered a
traumatic brain injury, and 53 kids who suffered a non-head injury.
An average of one and a half years after the injury, parents and
teachers rated attention problems and internalizing problems like
anxiety higher for kids with TBI. Parents also rated externalizing
problems, like aggression, higher for the kids with TBI.
Average reaction time was slower for kids in the TBI group than for
those in the other trauma group, the researchers found.
Ninety-one kids had moderate to severe TBI, meaning they lost
consciousness for more than 30 minutes and had posttraumatic amnesia
for at least an hour. This group scored lower on IQ tests and had
more lapses of attention than the 24 kids with mild TBI, according
to a report in Pediatrics.
Kids with mild TBI and extra risk factors like headache, vomiting or
seizures after their injury also had lower IQ scores and more lapses
of attention.
Because the attention problems persisted more than a year after the
injury, it is unlikely that they will resolve themselves over time,
Konigs said.
For more than 15 years now, researchers have known that "secondary
attention deficit hyperactivity disorder" can develop after brain
injury in children, according to Dr. Bradley L. Schlaggar, head of
the Division of Pediatric and Developmental Neurology at Washington
University School of Medicine in St. Louis, Missouri.
Schlaggar was not part of the new study.
“The kinds of daily life problems caused by attention deficits,
internalizing behaviors, and externalizing behaviors are numerous
and fairly self-evident,” he told Reuters Health by email. “An
impulsive child who is aggressive will have difficulty with
relationships, with school performance, with participation in
extracurricular activities, and so forth.”
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The consequences of TBI vary between children, depending on injury
severity and other factors, Konigs said.
Teachers and doctors should know that children with TBI can have
very short lapses in focus, and appear to process information
slower, he told Reuters Health by email.
Wearing helmets while bicycling and having separate bicycle lanes on
busy streets may reduce the risk of TBI, he said.
“There is only so much parents can do to minimize risk of an injury
but monitoring their child’s risk-taking behavior, modeling and
teaching skills that reduce risk of an injury, using protective gear
or devices, supervision, and monitoring of organized activities or
sports for aggressive or risky coaching or competition are all
helpful,” said Talin Babikian of the UCLA BrainSPORT Program in Los
Angeles, California, who was not part of the new study.
“Our research did not investigate treatment options for lapses of
attention, but other studies showed that stimulant treatment
(methylphenidate) successfully reduce lapses of attention in
children with ADHD and childhood cancer survivors, suggesting that
this treatment could potentially reduce lapses of attention in
children with TBI as well,” Konigs said.
SOURCE: http://bit.ly/1IeBi4Q Pediatrics, online August 3, 2015.
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