Kognitivno-komunikacioni poremećaj kod dece i adolescenata sa traumatskom povredom mozga

Abstract

Povećanjebroja traumatskih povreda mozgai svesti o mogućim trajnim psiho-socijalnim posledicama kod povređenih osoba doveli su do intenzivnijeg istraživanja uticaja povrede na kognitivno isocijalno funkcionisanje. Brojni empirijski podaci ukazuju na dugoročno ispoljavanje deficita u oblasti jezika, kognicije, komunikacije, emocija i ponašanja.Posebna pažnja posvećuje se kognitivnim i komunikacijskim deficitima. S ciljem boljeg razumevanja njihove prirode, u ovom radu razmatrani su deficiti u jezikuu odnosu na druge kognitivne funkcije, značajne za interpersonalnu komunikaciju.Empirijski podaci pokazuju da trauma mozga u detinjstvu dovodido poremećaja u razvoju ili gubitka već stečenih sposobnosti razumevanja figurativnog jezika, upotrebe jezika u različitim društvenim kontekstima,kao i diskursa. Navedeni poremećaji povezani sus deficitima pažnje, radne memorije,egzekutivnih funkcija i socijalne kognicije. U fokusu rada su iprepoznavanje kognitivno-komunikacionogporemećajakod dece, kao i metode procene. Takođe su prikazani pristupi u tretmanu dece i mladihs kognitivnim posledicama moždane povrede. Najzad, razmatran je oporavakjezičkih ikognitivnih funkcija nakon povrede glaveu detinjstvu u odnosu na težinu povrede iuzrast u vremenjenog nastanka. Vidljivo je da su dugotrajniporemećaji kognicije uglavnom posledica teške povrede mozga, mada i blage povrede mogu trajno oštetiti razvoj nekih psihičkih funkcija. S obzirom na ova saznanja, napušteno jetradicionalno shvatanje da kod dece sa stečenom povredom zbog plastičnosti nezrelog mozga dolazi do potpunog oporavka kognitivnih funkcija. S obzirom na mogućnost dugoročnog ispoljavanja poremećaja različitih aspekata kognicije i ponašanja, naglašavamo potrebukontinuiranog praćenja dece i adolescenata s traumatskom povredom mozga radi pružanja podrške za učenjei bolje socijalno funkcionisanje.

The increase in number of traumatic brain injuries and growing awareness of the possible lasting psychosocial consequences in the injured have led to increased research of the impact of injury on cognitive and social functioning. Numerous empirical data indicate a long-term manifestation of deficits in the areas of language, cognition, communication, emotions and behaviour. Special attention is paid to cognitive and communication deficits. In order to better understand their nature, this paper considers deficits in language in relation to other cognitive functions, which are important for interpersonal communication. Empirical data show that brain trauma in childhood leads to developmental disorders or loss of already acquired abilities to understand figurative language, use of language in different social contexts, as well as the organization of discourse. These disorders are associated with deficits in attention, working memory, executive functions and social cognition. The paper also focuses on the problems of recognizing cognitive-communication disorders in children, as well as assessment methods. Approaches to the rehabilitation of children and young people with the cognitive impairments caused by brain injury are also presented. Finally, the recovery of language and cognitive functions after a head injury in childhood was considered in relation to severity of injury and age at the time of its occurrence. Long-term cognition disorders are predominantly a consequence of severe brain injury, although mild injuries also can permanently impair the development of some mental functions. Given these findings, the traditional view that, due to the plasticity of the immature brain, a complete recovery of cognitive functions in children with acquired injury occurs was abandoned. Given the possibility of long-term manifestations of disorders of various aspects of cognition and behaviour, we emphasize the need for continuous monitoring of children and adolescents with traumatic brain injury to provide support for learning and better social functioning.