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Cognitive Communication Impairments in Children With Traumatic Brain Injury

A Scoping Review

Cermak, Carly A., MClSc; Scratch, Shannon E., PhD; Reed, Nick P., PhD; Bradley, Kim, PhD; Quinn de Launay, Keelia L., BAS; Beal, Deryk S., PhD

The Journal of Head Trauma Rehabilitation: March/April 2019 - Volume 34 - Issue 2 - p E13–E20
doi: 10.1097/HTR.0000000000000419
Pediatric TBI 2019

Objective: This scoping review synthesizes the scholarly literature on cognitive communication impairments in traumatic brain injury (TBI) sustained during childhood to identify gaps in research, and make recommendations that will further the field of cognitive communication in pediatric TBI.

Methods: MEDLINE, PsycINFO, CINAHL, and EMBASE were searched to identify peer-reviewed studies that examined cognitive communication impairments in children who sustained a TBI between 3 months to 18 years of age.

Results: Twenty-eight studies met inclusion criteria with 3 main categories identified in relation to cognitive communication: (1) impairments according to TBI severity, (2) impairments according to age at injury, and (3) trends in recovery according to TBI severity.

Conclusions: The results of this scoping review suggest that (1) TBI severity is not the sole predictor of performance; other factors contribute to cognitive communication outcome and recovery; (2) developing skills at time of injury are most susceptible to impairment; and (3) standard, norm-referenced language assessments are not sensitive in detecting language impairments that are secondary to cognitive impairments found in TBI. Directions for future research and suggestions for clinical practice are proposed.

Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Ontario, Canada (Mss Cermak and Quinn de Launay and Drs Scratch, Reed, and Beal); Rehabilitation Sciences Institute, University of Toronto, Ontario, Canada (Mss Cermak and Quinn de Launay and Drs Scratch, Reed, and Beal); Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Ontario, Canada (Ms Cermak and Dr Beal); Department of Pediatrics, University of Toronto, Ontario, Canada (Dr Scratch); Department of Occupational Science and Occupational Therapy, University of Toronto, Ontario, Canada (Dr Reed); and St Michael's Hospital, Toronto, Ontario, Canada (Dr Bradley).

Corresponding Author: Deryk S. Beal, PhD, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, ON M4G 1R8, Canada (

The first author received funding from Holland Bloorview Kids Rehabilitation Hospital Foundation in the form of a graduate scholarship. No direct sources of funding were supported for this article.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

The authors declare no conflicts of interest.

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