“Growing Into” a Brain Injury
Neurocognitive Stall or Late Effects of Brain Injury
One major difference between a brain injury experienced by a child as compared to an adult is that children’s brains are experiencing ongoing development. When an adult has a brain injury, the goal of therapy is to help them regain the skills they had developed before. When a child has a brain injury, the goal is to help them regain those skills... and acquire the next set of skills... and the next... and the next... and the next... When children experience a brain injury, their brain development may be interrupted in such a way that these later stages may be impacted as well. This is sometimes referred to as neurocognitive stall or the late effects of brain injury.
Growing into a Brain Injury
Following a brain injury, children often recover many previously acquired skills with both time and therapy. It is often more difficult for children to regain the developmental skills they were working on acquiring at the time of injury and, as a result, later developing skills which build upon these may be more challenging to acquire. These difficulties may not be noted until later in their development as they "grow into" their areas of deficit when demands within their environment increase. Often this means that young children who appear to have “bounced back” after a brain injury present with deficits later that may or may not be identified as related to their injury.
Common Areas of Deficit
Common areas of deficit for children who experience a brain injury at a young age include difficulties with language, attention, memory, behavior regulation, organization, inhibition, and reading. Common areas of deficit for children who experience a brain injury during school age years include difficulties with language organization, attention, memory, reading, and executive functioning skills.
Ongoing Monitoring
Children who experience brain injuries are at risk of difficulty when gaining later developing skills. Difficulties may be noted as demands increase at school such as when starting kindergarten, transitioning from learning to read to reading to learn (3rd grade), with increased courseload and responsibility when starting middle school and high school, and with increased cognitive demands such as completion of tests and essays which require a combination of analyzing, reasoning, and organizing abilities in addition to previously acquired language and cognitive communication skills. At these times, it will be important for appropriate school supports be re-evaluated to ensure your child is successful within his or her academic environment. A speech-language pathology re-evaluation and/or neuropsychological assessment is recommended at these transitional times.
About the Author
Brynn Schor, MS, CCC-SLP, CBIS (founder of Peninsula Specialty Speech Therapy, based in Menlo Park, California) specializes in assessment and treatment of cognitive communication deficits and executive function coaching for pediatric patients in the Bay Area and across California. Consultations provided worldwide.
