Memory Impairment
Memory impairment is another common area of concern after pediatric TBI. Typically, the memory impairment that is seen is for the formation of new memories as opposed to long-term memory.
This has significant implications for a child’s ability to learn new information. As observed in other areas, severity of memory impairment appears to be related to the overall severity of injury. Impairment is seen in both immediate and delayed recall in severe TBI (139-142). When evaluating preschool children who had experienced TBI, Anderson et al. (141) found that over time, children did show developmental progress in their memory skills; however, children with more severe TBI did less well over time. They saw this trend as well for both the learning and memory measures that they evaluated. It has been reported that verbal memory is more impaired than visual memory after TBI in children and that unstructured retrieval is the most impaired aspect of memory (143). Memory impairment is a challenging deficit to attempt to address during rehabilitation. Different approaches include trying to improve recall through memory practice, using organizational strategies or mnemonics, using teaching techniques to make learning more efficient (including backward chaining), or making use of compensatory techniques such as a memory notebook or electronic device (142,144,145). Avoiding purely verbal teaching, making use of structured activities in teaching, and increased repetition have been advocated as well (143).
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