Content area
Full Text
Acquired brain injuries (ABI) involve damage to the brain that occurs after birth and is not due to congenital or genetic causes. ABI are prevalent throughout childhood and adolescence and arise from a range of causes, including traumatic brain injury (TBI) and non-traumatic insults such as stroke, brain tumors, infections, and hypoxia. The adverse effects of pediatric ABI have been extensively documented; regardless of etiology, they can affect multiple domains, including physical, cognitive, social, adaptive, and behavioral functioning. Impairments caused by ABI typically follow a dose–response relation, with more severe and diffuse injuries resulting in worse and more persistent negative outcomes, often leading to lifelong impairments and poor quality of life.
Most research on the consequences of ABI focuses on the difficulties and deficits that occur as a result of the injury. In this context, it is easy to forget that some children with ABI exhibit surprisingly rapid or good recovery, display positive outcomes, and return to, or even exceed, pre-injury levels of functioning. Indeed, some children with ABI are able to adapt to their symptoms and sequelae, compensate for any impairments, succeed in academic, social, and community settings, and experience good quality of life.
Accounts of good recovery after ABI are readily available. For example, a subgroup of children with severe TBI show no deficits in one or more domains of functioning (neuropsychological, behavioral, adaptive, academic) between 6 months and 4 years postinjury (Fay et al., 2009). At the milder end of the TBI spectrum, most children who sustain mild TBI or concussion display no postconcussive symptoms or neuropsychological difficulties within 1 month of their injuries (Beauchamp et al., 2018; Zemek et al., 2016). Other ABI populations also display instances of positive outcome. Adolescents born extremely premature, many of whom sustain perinatal brain injuries, perceive their health and well-being as similar to term-born peers (Hack et al., 2011). Similarly, young adult survivors of childhood brain cancers report unexpectedly good health-related quality of life, which may be attributable to better coping mechanisms and greater optimism (Stam et al., 2006).
Research focusing on positive outcomes after ABI is increasing and has the potential to provide critical information on the factors that are protective or...