A brain injury has a devastating and lasting impact on a child. It can also lead to significant changes in family dynamics and adversely affect family finances. This year the Centers For Disease Control (CDC) reported an estimated $77.9 million annual healthcare price tag for pediatric TBI related services.
Children’s brains are still developing and differ significantly from a mature adult brain. In the early years of a child’s life, any trauma to the head can negatively impact brain development in a manner that has lifelong consequences. It is not uncommon for cognitive and behavioral changes to take months or years to become apparent. As an example, the frontal area of the brain begins to develop early in childhood and continues changing into early adulthood. Any trauma or injury to the frontal lobe area of a child’s brain may alter the natural development of social skills and impulse control. Because these are skills do not normally emerge as necessities of life until late adolescence, the full consequences of such an injury may go unnoticed for years.
Children with a history of TBI were more likely to have a variety of other health conditions compared with their peers without TBI, including learning disorders (21%), attention-deficit/hyperactivity disorder (21%%), speech/language problems (19%); developmental delay (15%), bone, joint, or muscle problems (14%); and anxiety problems (13%). Medscape
Common Causes of Traumatic Brain Injury in Children
Most childhood head trauma is attributed to motor vehicle accidents, falls, birth injuries, and recreational activities.
In a motor vehicle accident, closed head trauma to an unrestrained child can occur if the child’s head:
- Receives direct impact
- Is forcibly thrown forward and backward
- Thrashes about in an unexpected manner
An open head injury, also called a penetrating wound, is caused when the victim’s head is pierced by a sharp object, or the skull is fractured. This is severe, life-threatening trauma, and can require surgery to remove any bone fragments. This type of injury could, in many cases, cause permanent damage and impairment. Bleeding or swelling of the brain may also occur as the result of a penetrating injury.
Accidents happen, but the use of child restraints can often minimize the severity of the injury. Florida law requires children under 5 years old must be secured in a federally approved child restraint system:
- Children 3 years old and younger must use a separate car-seat or the vehicle’s built-in child seat.
- Children 4 through 5 years must sit in either a separate car seat, a built-in child seat or a seat belt, depending on the child’s height and weight
- Children under 18 years old must be in a seatbelt
Trip/Slip and Falls:
Slip and fall accidents can happen to children anywhere. Children commonly fall down on their own, but negligence on the part of the owner or manager of a property, or lack of supervision, may also lead to a child suffering an injury at school, in a daycare facility, or while visiting grocery stores, restaurants, movie theaters, amusement parks, or shopping centers.
Some causes of these slip and fall accidents include:
- Slippery floors
- Worn or torn carpeting
- Cracked and/or broken flooring
- Unsecured wires or cords
- Debris left in hallways or on walkways
- Uneven ground
- Broken pavement
- Dangerous stairs or handrails
- Poor maintenance of playground equipment
- Lack of supervision
Brain injuries during childbirth are often classified as:
- Mild brain injuries such as hematomas, or fractures
- Moderate brain injuries include brain bleeding, oxygen deprivation, and subdural hemorrhage
- Severe brain injuries put pressure on the brain and can result in seizures and underdevelopment of the brain itself
Doctors are often found at fault, or negligent, due to:
- Failure in providing a cesarean section when necessary
- Drug and/or medication errors
- A miscalculation of the baby’s size during childbirth
- Misuse of vacuums and forceps during delivery
Children’s injuries in school sports and recreational activities are common. Serious injuries, often with head trauma, are commonly found in the following sports:
- Roller skating
While participation in sports is the leading cause of concussions in adolescents and older children, small children and babies may also experience mild to severe head trauma from playing on swings and slides. Many factors contribute to a head injury while engaged in active physical play, including:
- Lack of adequate supervision
- Defective safety equipment
- Substandard equipment
- Improperly maintained swings or slides
Wearing a protective helmet can minimize head injury. When purchasing protective headgear for a child:
- Be certain the helmet fits properly
- Choose colors that are readily visible
- Select a helmet that meets the high standards of the Consumer Product Safety Commission or the Snell Memorial Foundation
A TBI can make it difficult for children to learn new skills. However, cognitive impairments of children may not be immediately obvious after the injury and may only emerge as the child ages and faces increased cognitive expectations and social situations. Pediatric brain injuries can have significant and devastating effects on a child’s ability to learn and to develop socially appropriate behavior.
Signs & Symptoms
Following any blow to the head watch for signs and symptoms of brain injury such as:
- Cranky or irritable behavior
- Persistent crying and inability to be consoled
- Eating habit changes
- Changes in sleep patterns
- Unexpected behavior changes
- Poor school performance
- A lack of interest in favorite activities or toys
- The loss of a newly acquired skill
- Unsteady walking, running or loss of balance
- A headache or “pressure” in the head.
- Nausea or vomiting.
- Balance problems, dizziness, double or blurry vision.
- Confusion, problems with memory or concentration
“Traumatic Brain Injury (TBI) continues to be one of the leading causes of death and disability in the pediatric population.” National Institute Of Health
Children with a TBI may have changes in their physical abilities largely because the brain’s nerve cells are no longer able to send and receive information in the way they did prior to the injury. Although some of these physical changes may resolve quickly, it is possible difficulties will last a lifetime.
Speech and language skills may be affected depending on the location and severity of the head injury.
Even though hearing and vision changes are sometimes present they can often go unnoticed immediately following an accident. Hearing problems may include:
- Loss of hearing in one or both ears
- Inability to tolerate some decibel ranges
Vision problems from head trauma may cause:
- Loss of visual acuity
- Double vision
- Visual field loss
- Spatial perception deficits
Other physical consequences of traumatic brain injury include:
- Intractable and/or persistent headache
- Lack of motor coordination
- Muscle spasticity
- Issues with balance
A brain injury can occur to a child without any apparent physical injury. Emotional and cognitive issues can be severe and life-changing. The greatest challenges many children with a brain injury face are changes in their abilities to think, learn, and develop socially appropriate behaviors.
Common deficits after brain injury include difficulty in learning new materials and processing information. Impaired judgment and reasoning ability may result in young people needing special individual accommodations in school. Neuropsychologists, psychologists, or specially-trained therapists may be able to evaluate and document the child’s academic strengths and limitations. Based on professional recommendations, examples of these special accommodations may include:
- The use of assistive technology
- Granting additional time to finish tasks
- Extended breaks
- Allowing oral tests
- Placement of the student at the front of the classroom
- Not requiring the child to read aloud in front of classmates
Cognitive and emotional impairments following a traumatic brain injury include:
- Issues with memory and concentration
- Limited attention span
- A difficulty with language skills and communication
- Reduced perception
- Poor writing skills
- Mood swings
- Low self-esteem
- Lack of motivation
There is a broad spectrum of complexities in traumatic brain injuries in children, adolescents, and young adults. The ability to use language correctly and associated skills such as attention, memory, self-awareness, organization and problem-solving are both frustrating and frightening to both the young victims and their family support systems.
Long-term developmental challenges following a brain injury are easily, and often, overlooked. It is frequently believed a child’s body is resilient and will recover quickly. The sad truth is, while a child may look okay immediately following a head injury, educational, behavioral, and social problems have a tendency to surface years after an injury.
Any head trauma in a pediatric victim can cause damage to the brain. Whether caused by a motor vehicle accident (car, bus, or motorcycle,) a bicycle accident, a slip, and fall accident, or an accident at birth, a brain injury can profoundly affect a child’s future. Pediatric brain injuries are often associated with the following symptoms:
- Motor skill deficiencies and disabilities
- Short attention span or difficulty concentrating
- Memory loss or impairment
- Difficulty learning new information
- Limited ability to follow patterns and sequences
- Impulsive behavior and lack of self-control
“Research demonstrates that the younger a child at the time of injury, the greater the possibility of long-term developmental challenges.”
~Brainline, All About Brain Injury and PTSD
When a family is faced with a TBI, incomes shrink, expenses soar, and financial stability can be shattered. A victim of a traumatic brain injury will face the prospect of a lifetime of decreased earning potential. Children who suffer pediatric brain injuries can often expect long-term treatments and possibly a need for around-the-clock skilled nursing care. Meeting these needs is expensive and insurance policies may not cover the associated costs. The financial aspects of care following a traumatic brain injury can impose a lifetime burden on a child’s family. Providing appropriate and comprehensive care for an injured child can leave entire family units financially strapped and dependent on federal and state public programs, and supplemental security income. Expert financial analysts can help evaluate potential costs of long-term life care. In addition to the immediately lost wages of the parents following the accident, be prepared for:
- Costs of follow-up care
- Possible surgery
- Rehabilitation costs for physical, occupational and cognitive therapy
- Adaptive equipment
- Modifications to living environments
It Takes a Care Team
Integrating a brain-injured child back into the community may require a care team, to include:
- A Physiatrist to monitor and treat conditions that affect functional activities
- A Neuropsychologist to evaluate cognitive functions and behavior
- An Occupational Therapist to improve motor, visual, cognitive and sensory processing functions.
- A Physical Therapist to facilitate physical independence
- A Speech Pathologist to improve communication, problem-solving and oral motor skills
Each family member is a critical part of a quality and effective care team. Family-centered care provides much-needed support and encouragement in the recovery process. Support groups can help family members better understand brain injuries, and provide coping skills.
Help Is Available
This statistic is staggering. The Brain Project tells us every 40 seconds a youth enters an emergency department with a brain injury. There is a wealth of valuable information and resources on their website.
The Heads Up web page from the CDC site can help parents understand serious pediatric brain injuries.
The Florida Institute for Neurologic Rehabilitation. (FINR) was founded in an effort to provide high quality, clinically relevant, and cost-effective brain injury rehabilitation and support living services.
To find a support group in your area visit Brainandspinalcord.org
The Brain and Spinal Cord Injury Program is administered by the Florida Department of Health. The program’s purpose is:
To provide all eligible residents who sustain a traumatic brain or spinal cord injury the opportunity to obtain the necessary services that will enable them to return to an appropriate level of functioning in their community. Funding for the program is through traffic-related fines, temporary license tags, motorcycle specialty plates and general revenue.
Contact the The Offices of Bob Loblaw, P.A., if you suspect your child’s traumatic brain injury could have, or should have, been prevented. We offer a free consultation to discuss your potential brain injury case. We have extensive experience helping the families of young TBI victims deal with the complexities of this challenging area of personal injury law.
Call today to speak with an experienced and compassionate personal injury attorney.