Advances in Understanding the Outcomes of Pediatric Traumatic Brain Injury: From Baby Steps to Bigger Leaps.

This Special Communication reflects on progress in understanding the outcomes of pediatric traumatic brain injury (TBI) since the Journal of Head Trauma Rehabilitation special issue (volume 1, issue 4) on "head injury" in children appeared in 1986. We highlight the critical role that prospective, longitudinal cohort studies have played in advancing knowledge about both mild and moderate-severe pediatric TBI. We describe conceptual and methodological innovations that the past 40 years of research has spurred and summarize remaining challenges. These include the need for comparative effectiveness and randomized controlled trials to determine what interventions are effective, singly or in combination, as well as for implementation science to translate research into clinical practice, with the goal being to provide better care and improve outcomes for children with TBI and their families.