Head injured children and education: a need for greater delineation and understanding.

There is continuing professional misunderstanding within education and psychology regarding the effects of head injury upon the immature brain. Children who sustain repeated mild, or single severe head injuries in falls, road accidents, or as victims of physical abuse, may look good but perform badly. There is no acceptable evidence that such children achieve a good or full recovery. Conclusions about good prognosis cannot be substantiated in the present state of inadequate assessment including the perpetual reliance on inadequate or inappropriate global estimates, such as IQ, or Glasgow Outcome scores. The basis of many problems for head injured children within education is the apparent failure to adequately delineate the variables of mechanism and severity of injury, age at insult and time since injury.