By Patrick J. McGrath, OC, PhD, FRSC
Question:
My daughter is in her teens; since she was about three, we knew she was not catching on to things as fast as she should. Thirteen years later, she looks like your average teenager but she is definitely behind intellectually. This is very hard on her because the other kids sometimes shun her. She was seen by a neurologist and he said he didn't know why she was like this. He suggested that I stay very involved in her schooling and helping her make everyday decisions. There have been some learning disabilities in the family but none like this. Recently, I remembered that when she was two, I was carrying her from the pool to the change room, I slipped, and she hit her head hard. She was a tough kid and only cried for a minute maybe and then seemed to be herself again. Do you think this could have something to do with her problems today?
Dr. Pat responds:
It is sensible for parents to search for a cause, to understand why their child has difficulty learning. Often, however, no cause can be found.
The advice you received from the neurologist was sensible. It is important for all of us to be involved in our children's schooling but this is especially important if our child has some learning problems.
Mild head injuries do not lead to learning problems
Mild head injuries are common and, fortunately, do not cause severe problems.
The best scientific evidence is that children who have mild head injuries are no different in their long-term intellectual outcomes than children who have not had any head injuries. There is conflicting evidence that children with mild head injury may have a bit more of a problem with paying attention and being impulsive. Many studies find no difference if the tendency for impulsive children to cause themselves more head injuries is taken into account. Almost all of the research has been done with children with more serious head injuries than that sustained by your daughter. Most of these studies are on children admitted to hospital. There needs to be more research in this area.
Your daughter's bump on the head is probably not related to her learning problems because:
- She did not lose consciousness.
- She recovered in minutes.
- There was no evidence of effects at the time.
- She has not had multiple head injuries.
Severe or repeated head injuries can lead to learning problems
Severe or repeated head injury can cause serious learning problems in children. That is why it is critical to protect children from head injuries.
The most common causes of serious head injury in children are:
- falls
- vehicle crashes
- getting hit by a car
- child abuse
Preventing head injuries
Families can do a lot to prevent head injuries:
- Don't leave an infant on the change table.
- Make sure that your home is safe.
- Teach your child traffic safety.
- Use car seats appropriately.
- Control your frustration.
Patrick J. McGrath OC, PhD, FRSC is a clinical psychologist and a researcher. He is Professor of Psychology, Pediatrics, and Psychiatry at Dalhousie University and Vice President - Research at IWK Health Centre in Halifax. He is also the CEO of the Strongest Families Institute, which provides mental health care to families across Canada.
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