The impact of mild developmental learning difficulties on neuropsychological recovery from head trauma

Objectives: To investigate the prevalence of mild developmental learning difficulties (MDLD) in a group of patients who had sustained head trauma, to determine the impact on cognitive and neurobehavioural recovery.

Methods: A case-control design comprised 136 consecutive cases (55 MDLD; 81 control). Information regarding a history of MDLD was obtained during clinical interview, with neurobehavioural problems recorded using a checklist. Neuropsychological assessment and questionnaire measures of anxiety and depression were completed.

Results: Between group cognitive differences were only found on Digit Symbol (p < 0.01) and Trails B (p < 0.05) tests. The MDLD group reported a higher incidence of impulsive aggression and mood swings (both p < 0.01). Adjustment problems in the MDLD group were inferred from higher anxiety and depression ratings (both p < 0.05).

Conclusions: The MDLD group did not appear to display a more generalized deficit in cognitive functions. However, neurobehavioural problems, plus the incidence and degree of affective changes, suggest greater psychological vulnerability than controls.