Recovery and Outcome
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Recovery and Outcome from Acquired Brain Injury
Developmental Expression of Symptoms
The cognitive, physical and/or behavioral effects of moderate to severe Traumatic Brain Injury (TBI) vary both in terms of rate of recovery and the time at which the effects will manifest themselves. Some of the symptoms may appear early and go away with time. Others may appear immediately after the injury and never go away. Some injured children will develop skills but at a slower rate than normal (illustration 1), with a decreased likelihood of ever "catching up." Others show early medical and neurological recovery and then "grow into" their symptoms with the passage of time (illustration 2).
The consequences of TBI always need to be interpreted in the context of the child's stage of psychosocial development. For example, as a part of normal adolescent development, children encounter predictable changes in body image, peer group interactions and sexuality. An adolescent who has sustained a TBI recently or in years past may find themselves struggling even more with these issues. Alterations in mobility or general physical appearance may create distortions in body image. Abnormalities in language and social perception may cause additional confusion and isolation with peers. Impulsivity, impaired judgement and awareness at a time of increased experimentation with sexuality may lead to closer supervision by parents and teachers, just as the adolescent is also attempting to exert their independence and autonomy. For a more thorough discussion of these issues see
Lehr (1990).