Higher cortical dysfunction is one of the most important aspects to be considered in pediatric acquired brain injury(ABI)rehabilitation. Recently, higher cortical dysfunction has attracted attention in the medical community and consequently many trials have been carried out, but most of these were only for adults. This review relates the introduction of pediatric ABI rehabilitation therapy in our rehabilitation center. Higher cortical dysfunction treatments in children seem to show better recovery results than treatments in adults because a child's brain has more plasticity. The main etiology of ABI in children is traumatic brain injury(TBI)and acute encephalitis/encephalopathy. The characteristic symptoms are memory disturbance and attention deficit in TBI, and visual problems in acute encephalitis/encephalopathy. It is important for children with higher cortical dysfunction to be enrolled in special education programs and to be cared for under the cooperation of their respective rehabilitation centers, schools and homes.

Objective：To investigate the living conditions of patients who had experienced childhood onset of higher brain dysfunction and determine their problems with respect to diagnosis, school re-enrollment, and employment.Subjects and Methods：A retrospective investigation was performed in 196 subjects (122 men and 74 women) enrolled in the seven supporting centers in Japan for patients with higher brain dysfunction who were injured (or developed primary diseases) and diagnosed with higher brain dysfunction under 18 years old, and were not older than 40 at the time of investigation.Results：Primary diseases included traumatic brain injury (109 patients), cerebrovascular disease (35), encephalitis/encephalopathy (27), brain tumor (17), and brain hypoxia (8). Forty-two patients (21％) were diagnosed with higher brain dysfunction ≥1 year after brain damage and 64 (33％) started receiving support ≥1 year after brain damage. Of those who were re-enrolled in schools, 6％ left high schools and 17％ left colleges before graduation, mainly because of maladjustment to school life. Thirty-three (47.8％) among 69 patients who were ≥20 years were employed at the time of investigation, and 19％ were living on remuneration alone.Conclusion：To resolve problems in patients with childhood-onset higher brain dysfunction, it is necessary to establish early diagnosis as well as collaboration systems among medical, educational, and welfare institutions to support these patients.

Objective：To investigate the living conditions of patients who had experienced childhood onset of higher brain dysfunction and determine their problems with respect to diagnosis, school re-enrollment, and employment.Subjects and Methods：A retrospective investigation was performed in 196 subjects (122 men and 74 women) enrolled in the seven supporting centers in Japan for patients with higher brain dysfunction who were injured (or developed primary diseases) and diagnosed with higher brain dysfunction under 18 years old, and were not older than 40 at the time of investigation.Results：Primary diseases included traumatic brain injury (109 patients), cerebrovascular disease (35), encephalitis/encephalopathy (27), brain tumor (17), and brain hypoxia (8). Forty-two patients (21％) were diagnosed with higher brain dysfunction ≥1 year after brain damage and 64 (33％) started receiving support ≥1 year after brain damage. Of those who were re-enrolled in schools, 6％ left high schools and 17％ left colleges before graduation, mainly because of maladjustment to school life. Thirty-three (47.8％) among 69 patients who were ≥20 years were employed at the time of investigation, and 19％ were living on remuneration alone.Conclusion：To resolve problems in patients with childhood-onset higher brain dysfunction, it is necessary to establish early diagnosis as well as collaboration systems among medical, educational, and welfare institutions to support these patients.