Early developmental, behavioral, and quality of life outcomes following abusive head trauma in infants.

Abstract Background Developmental delays following pediatric abusive head trauma are common. Objective To assess early developmental, behavioral, and quality of life outcomes following infant abusive head trauma and evaluate injury severity and early therapeutic intervention as potential predictors. Participants and setting Infants under 12 months old who were admitted to a large pediatric hospital with abusive head trauma between October 2010 and October 2017 and followed at a multidisciplinary post-injury clinic were included. Methods Injury severity groups were classified based on days in the Pediatric Intensive Care Unit. Participation in early intervention services and/or physical or occupational therapy by the first clinic visit was documented. Development was assessed using the Mullen Scales of Early Learning, which 47 patients completed at approximately 6 month intervals up to 3 years of age (an average of 19 months post-injury). Behavior and quality of life were assessed around age 2 using the Child Behavior Checklist (n = 24) and PedsQL™ (n = 27), respectively. Results Overall cognitive development, fine motor function, and expressive language significantly declined with age up to 3 years (p   0.05). Conclusions Long-term comprehensive follow-up is recommended for children following abusive head trauma, as developmental delays and behavioral problems may present at later ages.