Although TBI can result in both motor and cognitive impairments, it is generally the cognitive impair­ments that most profoundly affect the individual’s ability to function.

As noted previously, the full extent of the child’s cognitive impairment may not be known until a significant time after injury, as deficits may not become apparent until the child is at a devel­opmental stage when one would anticipate that they would have a particular cognitive ability, such as abstract thinking or metacognition. In general, when children have been followed long-term after injury, those who were injured at a young age typically show more cognitive impairment than those injured later in childhood (129).