Early neuropsychological outcomes following pediatric acquired brain injury: a prospective longitudinal pilot study

Pediatric Acquired Brain Injury (ABI) represents a complex clinical condition with significant neuropsychological impact. While long-term outcomes are well-documented, the early post-acute phase remains under-investigated despite representing the optimal window for neuroplastic recovery and intervention. This prospective longitudinal pilot study characterized early neuropsychological outcomes in pediatric ABI over the first year post-injury. Sixteen children (aged 3-16) with non-progressive ABI underwent comprehensive neuropsychological assessment at early post-acute phase (T0) and ten children at one-year follow-up (T1). Despite preserved global intellectual functioning at baseline, participants showed significant domain-specific deficits in processing speed, auditory attention, inhibition, cognitive flexibility, and verbal memory. At T1, selective recovery patterns emerged with normalization of processing speed, cognitive flexibility, and verbal memory, while inhibitory control and verbal fluency remained impaired. Longitudinal analyses revealed statistically significant improvements in cognitive flexibility, verbal long-term memory, visuoconstructive skills, and text comprehension. Individual recovery trajectories demonstrated substantial variability, highlighting the heterogeneous nature of recovery and the need for personalized interventions. These preliminary findings identify specific deficits in fundamental neuropsychological skills during early phases post-ABI. Early comprehensive assessment and targeted multi-domain rehabilitation are crucial for addressing core deficits during this critical neuroplastic window. Larger-scale studies are needed to validate these recovery patterns and develop evidence-based interventions.