Outcome of closed head injury in Malaysian children: Neurocognitive and behavioural sequelae

L. C. Ong, V. Chandran, S. Zasmani, M. S. Lye

    Research output: Contribution to journalArticle

    10 Citations (Scopus)

    Abstract

    Objective: To compare the neurobehavioural outcome of children aged 6- 12 years with severe closed head injury [sCHI] (coma >24 h), mild-to-moderate head injury [mCHI] (coma <6 h) and orthopaedic controls. Methods: Twenty- nine children in each group, matched for age, sex and ethnicity, were assessed using the Glasgow Outcome Scale (GOS), Weschler Intelligence Scale for Children (WISC-III), Movement Assessment Battery for Children (Movement ABC), Wide Range Assessment of Learning and Memory (WRAML) and a standardised neurological examination 6 months post-injury. Parental reporting of pre- and post-injury behaviour was documented using the Child Behaviour Checklist {CBCL). Results: Seven (24.1%) children with sCHI and three (10.3%) orthopaedic controls had residual motor deficits. Three (10.3%) children with sCHI and none in the other groups faced problems with independent ambulation. Twenty-seven (93.1%) of those with sCHI and all children in the other groups had GOS scores of good recovery or moderate disability. Twenty-two (81.5%) sCHI, five (18.5%) mCHI and one (3.7%) orthopaedic control reported a deterioration in school performance. MANOVAS identified a significant injury group effect for performance skills (P=0.007), Verbal skills (P=0.002), memory and learning (P=0.001) and motor skills (P= 0.001). Repeated measures ANOVA for pre- and post-injury CBCL scores showed significant differences related to somatic complaints (P = 0.004), problems of socialising (P = 0.003), delinquency (P = 0.004), aggressiveness (P = 0.010), thought (P<0.001) and attention (P<0.001). Post-hoc univariate analysis showed the significant differences were between that of the sCHI children and the other two groups. Conclusion: Although most sCHI children seemed to have made good physical recovery, there were cognitive, motor, memory and learning difficulties and behavioural problems concomitant with a deterioration in school performance compared with those with lesser or no head injury. This highlights the need for better integrated rehabilitation services to enable a gradual return into mainstream school.

    Original languageEnglish
    Pages (from-to)363-368
    Number of pages6
    JournalJournal of Paediatrics and Child Health
    Volume34
    Issue number4
    Publication statusPublished - 1998

    Fingerprint

    Closed Head Injuries
    Wounds and Injuries
    Glasgow Outcome Scale
    Orthopedics
    Child Behavior
    Learning
    Coma
    Checklist
    Craniocerebral Trauma
    Motor Skills
    Neurologic Examination
    Intelligence
    Walking
    Analysis of Variance
    Research Design
    Rehabilitation
    Age Groups

    Keywords

    • Children
    • Head injury
    • Neurobehavioural outcome

    ASJC Scopus subject areas

    • Pediatrics, Perinatology, and Child Health

    Cite this

    Outcome of closed head injury in Malaysian children : Neurocognitive and behavioural sequelae. / Ong, L. C.; Chandran, V.; Zasmani, S.; Lye, M. S.

    In: Journal of Paediatrics and Child Health, Vol. 34, No. 4, 1998, p. 363-368.

    Research output: Contribution to journalArticle

    Ong, L. C. ; Chandran, V. ; Zasmani, S. ; Lye, M. S. / Outcome of closed head injury in Malaysian children : Neurocognitive and behavioural sequelae. In: Journal of Paediatrics and Child Health. 1998 ; Vol. 34, No. 4. pp. 363-368.
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    abstract = "Objective: To compare the neurobehavioural outcome of children aged 6- 12 years with severe closed head injury [sCHI] (coma >24 h), mild-to-moderate head injury [mCHI] (coma <6 h) and orthopaedic controls. Methods: Twenty- nine children in each group, matched for age, sex and ethnicity, were assessed using the Glasgow Outcome Scale (GOS), Weschler Intelligence Scale for Children (WISC-III), Movement Assessment Battery for Children (Movement ABC), Wide Range Assessment of Learning and Memory (WRAML) and a standardised neurological examination 6 months post-injury. Parental reporting of pre- and post-injury behaviour was documented using the Child Behaviour Checklist {CBCL). Results: Seven (24.1{\%}) children with sCHI and three (10.3{\%}) orthopaedic controls had residual motor deficits. Three (10.3{\%}) children with sCHI and none in the other groups faced problems with independent ambulation. Twenty-seven (93.1{\%}) of those with sCHI and all children in the other groups had GOS scores of good recovery or moderate disability. Twenty-two (81.5{\%}) sCHI, five (18.5{\%}) mCHI and one (3.7{\%}) orthopaedic control reported a deterioration in school performance. MANOVAS identified a significant injury group effect for performance skills (P=0.007), Verbal skills (P=0.002), memory and learning (P=0.001) and motor skills (P= 0.001). Repeated measures ANOVA for pre- and post-injury CBCL scores showed significant differences related to somatic complaints (P = 0.004), problems of socialising (P = 0.003), delinquency (P = 0.004), aggressiveness (P = 0.010), thought (P<0.001) and attention (P<0.001). Post-hoc univariate analysis showed the significant differences were between that of the sCHI children and the other two groups. Conclusion: Although most sCHI children seemed to have made good physical recovery, there were cognitive, motor, memory and learning difficulties and behavioural problems concomitant with a deterioration in school performance compared with those with lesser or no head injury. This highlights the need for better integrated rehabilitation services to enable a gradual return into mainstream school.",
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    AU - Lye, M. S.

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    N2 - Objective: To compare the neurobehavioural outcome of children aged 6- 12 years with severe closed head injury [sCHI] (coma >24 h), mild-to-moderate head injury [mCHI] (coma <6 h) and orthopaedic controls. Methods: Twenty- nine children in each group, matched for age, sex and ethnicity, were assessed using the Glasgow Outcome Scale (GOS), Weschler Intelligence Scale for Children (WISC-III), Movement Assessment Battery for Children (Movement ABC), Wide Range Assessment of Learning and Memory (WRAML) and a standardised neurological examination 6 months post-injury. Parental reporting of pre- and post-injury behaviour was documented using the Child Behaviour Checklist {CBCL). Results: Seven (24.1%) children with sCHI and three (10.3%) orthopaedic controls had residual motor deficits. Three (10.3%) children with sCHI and none in the other groups faced problems with independent ambulation. Twenty-seven (93.1%) of those with sCHI and all children in the other groups had GOS scores of good recovery or moderate disability. Twenty-two (81.5%) sCHI, five (18.5%) mCHI and one (3.7%) orthopaedic control reported a deterioration in school performance. MANOVAS identified a significant injury group effect for performance skills (P=0.007), Verbal skills (P=0.002), memory and learning (P=0.001) and motor skills (P= 0.001). Repeated measures ANOVA for pre- and post-injury CBCL scores showed significant differences related to somatic complaints (P = 0.004), problems of socialising (P = 0.003), delinquency (P = 0.004), aggressiveness (P = 0.010), thought (P<0.001) and attention (P<0.001). Post-hoc univariate analysis showed the significant differences were between that of the sCHI children and the other two groups. Conclusion: Although most sCHI children seemed to have made good physical recovery, there were cognitive, motor, memory and learning difficulties and behavioural problems concomitant with a deterioration in school performance compared with those with lesser or no head injury. This highlights the need for better integrated rehabilitation services to enable a gradual return into mainstream school.

    AB - Objective: To compare the neurobehavioural outcome of children aged 6- 12 years with severe closed head injury [sCHI] (coma >24 h), mild-to-moderate head injury [mCHI] (coma <6 h) and orthopaedic controls. Methods: Twenty- nine children in each group, matched for age, sex and ethnicity, were assessed using the Glasgow Outcome Scale (GOS), Weschler Intelligence Scale for Children (WISC-III), Movement Assessment Battery for Children (Movement ABC), Wide Range Assessment of Learning and Memory (WRAML) and a standardised neurological examination 6 months post-injury. Parental reporting of pre- and post-injury behaviour was documented using the Child Behaviour Checklist {CBCL). Results: Seven (24.1%) children with sCHI and three (10.3%) orthopaedic controls had residual motor deficits. Three (10.3%) children with sCHI and none in the other groups faced problems with independent ambulation. Twenty-seven (93.1%) of those with sCHI and all children in the other groups had GOS scores of good recovery or moderate disability. Twenty-two (81.5%) sCHI, five (18.5%) mCHI and one (3.7%) orthopaedic control reported a deterioration in school performance. MANOVAS identified a significant injury group effect for performance skills (P=0.007), Verbal skills (P=0.002), memory and learning (P=0.001) and motor skills (P= 0.001). Repeated measures ANOVA for pre- and post-injury CBCL scores showed significant differences related to somatic complaints (P = 0.004), problems of socialising (P = 0.003), delinquency (P = 0.004), aggressiveness (P = 0.010), thought (P<0.001) and attention (P<0.001). Post-hoc univariate analysis showed the significant differences were between that of the sCHI children and the other two groups. Conclusion: Although most sCHI children seemed to have made good physical recovery, there were cognitive, motor, memory and learning difficulties and behavioural problems concomitant with a deterioration in school performance compared with those with lesser or no head injury. This highlights the need for better integrated rehabilitation services to enable a gradual return into mainstream school.

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