BRAIN INJURY: THE EFFECTS OF AGE-AT-ONSET AND CAUSAL AGENT ON LATER ADAPTIVE FUNCTIONING IN CHILDREN
Abstract
The present study investigated the effects of age at onset and etiology of brain damage on later adaptive functioning in children. Several conflicting views on this subject have been reported in the research literature. These views are based on findings that support a direct relationship between age at onset and severity of later psychological sequelae, those that support an inverse relationship, those that support the view that varying ages at onset result in qualitatively different, task dependent sequelae and those that take into account the etiology of the injury. The study examined those relationships by comparing the results of sixteen test scores for sixty-one children aged eight to eleven years who had suffered either early (before age three) onset of brain injury or relatively late (between ages four and seven) onset. Efforts were also made to compare two etiologically different groups on the sixteen dependent measures. The two groups were; subjects who had suffered closed head injury and those who has suffered acute infectious or metabolic illness that affected the cerebral hemispheres. The dependent measures assessed a wide range of adaptive abilities including cognitive, academic, sensori-motor and social-behavioral skills. Chi-square analysis of the groups of subjects failed to reveal significant differences for age at testing, age at onset between diagnostic groups, sex, race, or socio-economic status. The scores from the sixteen dependent measures were analysed using; (1) separate 2 x 2 univariate analysis of variance, (2) multivariate analysis of variance, and, (3) factor analysis followed by 2 x 2 analysis of variance of the derived factor scores. All three analyses revealed that early onset of brain injury has more deleterious effects on later adaptive functioning than late onset. The effects of etiology were less striking, but significant results indicated that closed head injury had more deleterious effects than infectious or metabolic illness. The results were discussed with respect to their relationship to the existing literature, implications for future research, prevention and early intervention measures. The use of factor analytic techniques showed promise for the identification of patterns of deficits in brain-injured children.
This paper has been withdrawn.