From Setbacks to Outlooks: Cognitive-Linguistic Outcomes Following Pediatric TBI: A Scoping Review

S. Reichelt; K. Leonie; K. Demmler; A. Häfele; J. Konrad; J. Wagner; R. Ritter; M. Bonfert; J. Büttner-Kunert

doi:10.1055/s-0045-1812164

Neuropediatrics, Inhaltsverzeichnis

Neuropediatrics 2025; 56(S 01): S1-S24
DOI: 10.1055/s-0045-1812164

Varia

From Setbacks to Outlooks: Cognitive-Linguistic Outcomes Following Pediatric TBI: A Scoping Review

Authors

S. Reichelt

¹Concussion Clinic, Kinderklinik und Poliklinik im Dr. von Haunerschen Kinderspital & integrierten Sozialpädiatrischen Zentrum (iSPZ Hauner), LMU Klinikum München, München, Germany
K. Leonie

²LMU, Ludwig-Maximilian University Munich, Department 13, German Philology, Speech-Language Therapy, München, Germany
K. Demmler

¹Concussion Clinic, Kinderklinik und Poliklinik im Dr. von Haunerschen Kinderspital & integrierten Sozialpädiatrischen Zentrum (iSPZ Hauner), LMU Klinikum München, München, Germany
A. Häfele

¹Concussion Clinic, Kinderklinik und Poliklinik im Dr. von Haunerschen Kinderspital & integrierten Sozialpädiatrischen Zentrum (iSPZ Hauner), LMU Klinikum München, München, Germany
J. Konrad

¹Concussion Clinic, Kinderklinik und Poliklinik im Dr. von Haunerschen Kinderspital & integrierten Sozialpädiatrischen Zentrum (iSPZ Hauner), LMU Klinikum München, München, Germany
J. Wagner

¹Concussion Clinic, Kinderklinik und Poliklinik im Dr. von Haunerschen Kinderspital & integrierten Sozialpädiatrischen Zentrum (iSPZ Hauner), LMU Klinikum München, München, Germany
R. Ritter

¹Concussion Clinic, Kinderklinik und Poliklinik im Dr. von Haunerschen Kinderspital & integrierten Sozialpädiatrischen Zentrum (iSPZ Hauner), LMU Klinikum München, München, Germany
M. Bonfert

¹Concussion Clinic, Kinderklinik und Poliklinik im Dr. von Haunerschen Kinderspital & integrierten Sozialpädiatrischen Zentrum (iSPZ Hauner), LMU Klinikum München, München, Germany
J. Büttner-Kunert

²LMU, Ludwig-Maximilian University Munich, Department 13, German Philology, Speech-Language Therapy, München, Germany

Abstract

Volltext

Background/Purpose: Traumatic brain injury (TBI) in children and adolescents can impair cognitive-linguistic development, affecting academic and social functioning. Despite high prevalence, outcomes across all severities are understudied. This scoping review maps current research on cognitive-linguistic consequences of pediatric TBI.

Methods: A systematic search was conducted in PubMed, OVID, Psyndex, Web of Science, LLBA, ERIC, PsycINFO, and Cochrane Library. Included were studies with participants aged 5 to 18, TBI of any severity, ≥5 subjects, and at least one cognitive-linguistic outcome. Studies involving preexisting developmental or behavioral conditions were excluded.

Results: From 55,344 records, 26,111 abstracts were screened, 689 full texts reviewed, and 62 studies (1987–2020) included. Most used the Glasgow Coma Scale to classify severity and originated from the United States, Canada, Australia, Sweden, or Italy. Both standardized and nonstandardized tools assessed outcomes. Younger age at injury correlated with more severe long-term deficits, especially if TBI occurred before key literacy or metacognitive development. Impairments appeared in abstract reasoning, figurative language, pragmatics, fluency, morphosyntax, and narrative coherence. Cognitive domains like working memory, processing speed, and executive function were closely linked to language performance. Socioeconomic status and family functioning strongly influenced recovery, sometimes more than lesion-related factors. Children with mild TBI often improved over time; severe cases showed lasting deficits.

Conclusion: Pediatric TBI is linked to deficits in cognition, language, and literacy. There is a need for sensitive diagnostics and interventions focused on real-world communication. Future research should standardize outcomes, cover all severities, and support long-term academic and social development.