Short term outcomes of children with abusive head trauma two years post injury: A retrospective study

Issue title: COVID-19’s Impact on the Practice of Pediatric Rehabilitation Medicine: Insights and Recommendations

Guest editors: Matthew McLaughlin and Christian Vercler

Article type: Research Article

Authors: Badger, Sarah^{a; *} | Waugh, Mary-Clare^{b; c} | Hancock, Jan^b | Marks, Susan^d | Oakley, Karen^{b; e}

Affiliations: [a] The University of Notre Dame, Sydney, Darlinghurst, NSW, Australia | [b] Kids Rehab, The Children’s Hospital at Westmead, Westmead, NSW, Australia | [c] Sydney Medical School, University of Sydney, Sydney, NSW, Australia | [d] Child Protection Unit, The Children’s Hospital at Westmead, Westmead, NSW, Australia | [e] The Children’s Hospital at Westmead Clinical School, University of Sydney, Sydney, NSW, Australia

Correspondence: [*] Corresponding author: Sarah Badger, School of Medicine, The University of Notre Dame, Sydney, Darlinghurst, NSW, Australia. Tel.: +61 402 742 055; E-mail: sarahbadger55@gmail.com.

Abstract: PURPOSE: Abusive head trauma (AHT) can have debilitating sequelae for children who survive. A retrospective medical record review was used to describe short-term developmental outcomes of children with AHT and identify predictors of poorer outcomes. METHOD: Children with AHT who received follow up by the hospital’s rehabilitation department for 12 to 24 months post-injury were included in this review. Data for 85 children were collected on hearing, vision, gross motor, fine motor, speech and language, cognition, play, adaptive functioning, behaviour and personal-social skills. RESULTS: Global assessment found 42% of children had a good recovery, 34% had a moderate disability and 24% had a severe disability. For whom there was data, more than half had abnormal cognition, behaviour and personal-social skills, whilst more than a third had abnormal speech and language, neurological signs on last assessment, vision, play skills, and gross and fine motor skills. Factors that predicted poorer prognosis across all developmental domains included paediatric intensive care unit admission, longer length of hospital stay, breathing difficulty and lower Glasgow Coma Scale on presentation. CONCLUSION: This study highlights the substantial number of children who have abnormal development in the short-term post-AHT and assists in identifying those who require extensive long-term follow up.

Keywords: Abusive head trauma, developmental outcomes, paediatric rehabilitation, paediatric brain injury, shaken baby syndrome

DOI: 10.3233/PRM-190624

Journal: Journal of Pediatric Rehabilitation Medicine, vol. 13, no. 3, pp. 241-253, 2020