A Look at Head Trauma
Head trauma is a common occurrence during childhood and adolescence. It would appear that the average "coming of age" bumps and bruises seems to demonstrate a specific pattern. During our various stages of child development we all experience the wonders of middle childhood, where over the span of just a few years we gain control over our body and our minds. Just as we have learned to identify people who are a type A personality, I believe there is a way to identify those people who are more prone to head trauma or head injuries.
During our developmental phases in middle childhood, the need and desire to become independent is strongly increasing. During this period of time, children are physically gaining greater gross and fine motor skills awareness and a better ability to use these new found skills. Children are challenging their physical strengths by testing their ability to grip objects, jumping vertically, running, balancing maneuvers on a bike, coordination skills, and judging distances, just to name a few. The mastery of which these skills are being used demonstrates new levels of independence.
Along with mastering these skills, that just years before we could not perform, we are excited to explore our surroundings by challenging our surroundings with our new abilities. For some children, the discovery of the vast improvement of their fine motor skills is enough to keep them captivated and out of harms way. However, there are children whose sense of adventure is not satisfied by a quick game of cat's cradle or SuperNintendo. Some kids want to climb mountains, race their bikes, snowboard or ski, and skateboard (the list goes on and on) and not all of these thrill seeking youths are properly protected with appropriate gear, especially headgear.
Perhaps there is a reason these children suffer from head injuries more than others. According to Tona McGuire, Phd and Michael Rothenberg, MD, studies have shown that head-injured children and adolescents who also had a psychiatric disorder were more likely to have come from a home with marital discord or divorce, to be from large (>4 siblings) families, and to have parents with a psychiatric disorder. (McGuire & Rothenberg, p. 5) They believed that the implications of a psychiatric disorder, particularly depression, in the parents demonstrates that not only is the child at risk for a psychiatric disturbance but also that the affected parents may not be providing adequate supervision which may lead to a child's injuries. These children are impulsive and engage in risk taking behavior.
These children may sometimes suffer from psychological disorders. A lot of these children may have been observed as being impulsive and having poor judgment in social situations which may contribute to being in situations where head injuries are more apt to occur. The fact that McGuire and Rothenberg (1986) discovered that a good number of head injured children were from either large families or divorced families sheds tremendous light on the effects our environment has on our behavior.
As I contemplate the meaning behind the findings that McGuire and Rothenberg (1986) discovered, I began to understand how a child from a divorced family or large family could fall into this category of high-risk head injury. According to research done by Hetherington, Stanley-Hagan, & Anderson (1989); Zill (1983); and Chase-Lansdale, Cherlin, & Kiernan (1995), in comparison to children with married parents, twice as many children from divorced families require psychological counseling (Feldman, 401). Perhaps a lack of understanding about the divorce, feelings of guilt and anger along with a need to be loved and given proper attention, some children look for way to vent these emotions and frustrations. Physical activity is an easily accessible way to manage some of this unfamiliar territory.
The transition from middle childhood to adolescence provides youths with a greater opportunity to obtain these head injuries. Body image becomes very important during this phase of development. Some activities to enhance body image can be harmful; like rock-climbing, backcountry skiing, kayaking, biking (road or mountain). The ability to drive also contributes to the increase in opportunities for injury. Lack of experience in driving automobiles and motorcycles provide a perfect opportunity for head trauma.
As with most phases of development there are differences between the sexes. Rivara MD and Mueller DrPH (1986) found that rates for head injuries for males were consistently about 1.3 to 2.0 times greater than those for females at all ages. The sex segregation that occurs during middle childhood carries over into adolescence continuing to support the stereotypes between boys and girls that boys are more aggressive and girls are more passive. However, through media influence, girls are no longer the passive youths of the past. They are venturing out into the hardcore world of sports and outdoor activities along side their male peers. With commercials like Mountain Dew glorifying "extreme" sports, adolescence are testing their physical boundaries more and more, increasing their risk of injury.
Head injuries can cause impairment in physical abilities, speech and language and cognition. Once the physical aliments have been healed or appropriately managed, there are still other injuries to adhere to. Motor speech disorders, language disorders and comprehension deficits can be detected through testing in children. Tests like WISC III, Stanford-Binet Intelligence Scale, and K-ABC are sometimes used to assess a child's level of intelligence and cognitive abilities. They are not the sole indicators of head injuries. Observation of a child's level of attention, perception, memory, organizing processing, reasoning skills, knowledge base and the level of age appropriateness in the execution of these skills contributes greatly to the understanding of a child with a head injury.
Once these observations have been made, treatment for youths with head injuries can take place. Depending on the severity of the head injuries most youths recover with little change in their every day routine. In children with more serious head injuries, recovery takes great effort, discipline and courage. Therapy for physical aliments can be easily arranged, while therapy for verbal and cognitive deficits may be a bit more challenging. A child's metalinguistic and metacognition play an important role in their recovery. Therapists are able to use the youth's ability to recognize their limitation and boundaries to help them recover from their not so obvious injuries.
Although accidents continue to happen on a daily basis, proper knowledge of preventative measures for head injuries can help reduce one's chances of becoming seriously injured. Helmets and common sense are probably the most powerful tools one can use to protect them from harms way while enjoying the finer thrill seeking adventures that life has to offer. With age comes the knowledge and experience to provide our children with the proper tools needed to live life to the fullest and remain injury free.
