Recent studies have shown that persisting deficits remain even in young children with mild brain injuries. Our 2-year study investigated patterns of recovery in children and adolescents with ABI over the past 10 years. In the first year, we retrospectively reviewed demographic information (e.g., age at injury, gender,severity, GCS, coma length, and LOS), medical status, academic and therapy interventions, psychological, emotional and cognitive,physical, social, and family issues reported by parents and clients and outcome data from an adapted version of the Mayo-Portland Adaptability Inventory. In the second year of the study, we prospectively collected in-depth information through the use of new outcome measures, questionnaires and structured interviews. We focused on the relationships between persisting limitations (academic performance, pragmatic communication, social interactions, and physical abilities) and restrictions on participation (i.e., school, social relationships, vocational,and quality of life) of children who are between 3 and 5 years post-injury.

The relative responsiveness of nine outcome measure scales was evaluated with 33 children and adolescents (aged 4-18 years) who had sustained traumatic brain injuries. Scales were selected to evaluate outcomes from each of the World Health Organization (WHO) International Classification of Functioning, Disability and Health domains. The outcome measures were administered to all participants during their inpatient rehabilitation stay and again at a follow-up clinic visit. No single outcome measure captured the diversity of improvement in this sample. The measures agreed that improvement had occurred, but did not agree about which children were improving. This result suggests that the scales were measuring different skills and outcomes. Three of the measures used in combination, either the Child Health Questionnaire or the Functional Independence Measure for Children, the American Speech-Language-Hearing Association National Outcome Measures System (Birth to Kindergarten NOMS/School-aged Health Care) and the Gross Motor Function Measure, are sufficient to detect change in each of the children where change occurred. The Pediatric Evaluation of Disability Inventory and the MultiAttribute Health Status Classification were the least responsive of the nine measures used.