Closed-Head Injury in Children: Neuropsychological and Scholastic Outcomes

Neuropsychological studies of head injury in children have not adequately reported outcomes in terms of specific scholastic deficiencies. Typically, Klonoff, et al. ( 2 ) found that about 2856 of their sample failed a grade, were in remedial classes, or dropped out of school. Chadw~ck and his colleagues ( 1 ) reported achievement test levels for reading and spelling in a group with depressed skull fracture. About 3056 of their sample was backward at reading, but no corresponding information was prov~ded for spelling nor was arithmetic tested. W e report rhe performance of 15 right-handed children (M age = 9.2 yr.) who sustained severe closed-head injury ( M coma = 9 days) at an early ( 3 to 6 mo. after coma) and (at least 1 yr. after coma) examination. The table shows the percentage of patients performing deficiently ( % of patients below the tenth percentile) on the Wechsler Intelligence Scale for Children-Revised, Wide Range Achievement Test, Purdue Pegboard, Benton Visual Retention Test, and Buschke Selective Reminding at the late follow-up. Performance IQ was more depressed initially and recovered more than Verbal IQ ( IQ type x session; Flnr = 8.9, P < .01). Time-in-coma covaried with over-all I Q (P < . 0 5 ) . Arithmetic was poorer than reading or spelling (FWs = 4.3, P < .02), an effect unaltered by introducing IQ or time-in-coma as covariates.