NEUROBEHAVIORAL OUTCOME OF HEAD INJURY IN CHILDREN

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 1.目的1：工作记忆、抑制和元认知技能的发育受损与急性脑缺血的严重程度和额叶残留病变的体积直接相关。与年龄较大的儿童发生的严重CHI相比，9岁之前发生的严重CHI对工作记忆、抑制和元认知技能发展的不利影响更大。 2.目标2：儿童颅脑损伤后的工作记忆、抑制和元认知技能发展不足与话语加工、学业成绩和适应技能的发展直接相关。 3.目的3：CHI后抑制和元认知技能受损的儿童患注意力缺陷/多动障碍(ADHD)和相关的外化障碍(即对立违抗障碍和品行障碍)的风险增加。创伤后内化障碍与伤前内化障碍和与创伤相关的心理应激有关。前额叶和/或基底额叶损害的存在、儿童或父母受伤前精神障碍的病史，以及不利的心理社会环境，都会增加CHI后发展为精神障碍的风险。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. 1. Aim 1: Impaired development of working memory, inhibition, and metacognitive skills is directly related to the severity of acute CHI and the volume of residual prefrontal lesions. Development of working memory, inhibition, and metacognitive skills is more adversely affected by severe CHI occurring before age 9 years as compared to the outcome of severe CHI occurring in older children. 2. Aim 2: Problems in discourse processing, scholastic achievement, and adaptive skills are directly related to deficient development of working memory, inhibition, and metacognitive skills following head injury in children. 3. Aim 3: Children whose inhibition and metacognitive skills are impaired following CHI are at increased risk for developing attention-deficit/hyperactivity disorder (ADHD), and related externalizing disorders (i.e., Oppositional-Defiant and Conduct Disorders). Posttraumatic internalizing disorders are related to preinjury internalizing disorders and the psychological stress associated with the injury. The presence of prefrontal and/or basotemporal lesions, history of a preinjury psychiatric disorder in the child or parents, and adverse psychosocial environment contribute to the increased risk of developing a psychiatric disorder following CHI.