NEUROBEHAVIORAL OUTCOME OF HEAD INJURY IN CHILDREN

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 研究中心，而研究中心不一定是研究者所在的机构。 1.目标1：工作记忆、抑制和元认知技能的发展受损与急性CHI的严重程度和残留前额叶病变的体积直接相关。 与年龄较大的儿童发生严重CHI的结果相比，9岁之前发生的严重CHI对工作记忆、抑制和元认知技能的发展产生更大的不利影响。 2.目标二：话语处理、学习成绩和适应技能方面的问题与儿童头部受伤后工作记忆、抑制和元认知技能的发展不足直接相关。 3.目标3：CHI后抑制和元认知能力受损的儿童患注意力缺陷/多动障碍（ADHD）和相关外化障碍（即，对立违抗和行为障碍）。 创伤后内化障碍与创伤前内化障碍和与创伤相关的心理应激有关。前额叶和/或基底颞叶病变的存在，儿童或父母的损伤前精神疾病史，以及不良的心理社会环境有助于CHI后发展为精神疾病的风险增加。

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.