Written language production and neuropsychological function in children with traumatic brain injury.

Abstract

To establish the early consequences of traumatic brain injury (TBI) on spontaneous written language production in children by examining writing deficits as a function of injury severity and correlating written performance with neuropsychological data. Case-control cohort study. Two regional medical centers. Seventy-six children, aged 8 to 15 years, with mild, moderate, or severe closed head injury were compared with controls who were individually matched on the premorbid characteristics of age, gender, school grade, behavior, and academic performance. Assessment of written language production and neuropsychological function was undertaken approximately 1 month following resolution of posttraumatic amnesia. Case-control differences on 16 measures of spontaneous written narratives were computed. Factor analysis and conceptual similarities suggested that the measures of written language fell into five domains: Efficiency, Completeness, General Readability, Error, and Vocabulary. A highly significant, moderate correlation between these measures and severity of injury was found. The highest correlations were found for the written language domains of Efficiency and Completeness and the lowest for the Vocabulary domain. Moderate correlations were also found between measures of written language and neuropsychological function. At 1 month after resolution of posttraumatic amnesia, written language production in children with TBI is negatively correlated with severity of injury. Some aspects of written language production are affected to a greater extent than others. Considerable common ground was found between written language production and neuropsychological function.