Cognitive indicators of vocational outcome after severe traumatic brain injury (TBI) in childhood

Recent studies suggest that plasticity does not benefit outcome when diffus e cerebral pathology of the young child's brain is concerned. Thirty-three patients with severe traumatic brain injury (TBI) at preschool age were fol lowed-up until adulthood. After the age of 18 years, a thorough neurologica l, neuropsychological and social evaluation, including detailed patient his tory and assessment of identity, was made by the team. When the youngest pa tients were 21 years old, the study was completed, with a questionnaire ass essing employment status and ability to live independently. Twenty-seven pe r cent of the patients worked full time, 21% had subsidised work, 37% lived independently at home and 15% needed help with every-day functions. Tests measuring speed, executive and memory functions were significantly associat ed with vocational outcome, as was the sense identity, which was independen t of the test scores. The results support the recent reports on the vulnera bility of a young child's brain to early trauma. The study also strongly su ggests that the final assessment of outcome after childhood TBI should be d one in adulthood.