One million people attend Accident and Emergency in the UK following a head injury. The two age groups at highest risk of sustaining a traumatic head injury are children aged 0 to 4 and between 15 and 19 years old.

There is no “one size fits all” when it comes to head injury, but children in particular tend to have more complicated symptomatology than adults. One reason for this is that the injury occurs in a child when their development is not yet complete. After trauma, the child’s brain has to try to develop when it has been damaged.

A child with a traumatic brain injury may find it harder to process information, which, for example, may mean they take longer to do their school work and to complete exams. Some children may be more distracted and may have difficulties maintaining concentration and focus. Some children may become socially disinhibited and lack sensitivity to others.

The compensation claim will be conducted on the child’s behalf by a litigation friend, which may be a parent or guardian. Adjusting to the changes of looking after an injured child and responding to the input from various new systems can be overwhelming for them as well.

Returning to school following a traumatic brain injury presents further challenges for the child. A brain injury is not visible to teachers and pupils in the same way as, say, a broken leg. Schools unfortunately vary as to their awareness of the symptoms and effects of a brain injury and the support they provide.

As part of a compensation claim the insurers can be asked to fund support to help the child in their school and home environment. We recently acted for a girl who was run over by a van on the way to school when she was nine years old. The insurers paid for a case manager to provide her with valuable support in adjusting to school life after her accident.

One of the challenges in a compensation claim involving a child with a brain injury is that the symptoms develop at the same time as other challenges associated with childhood and adolescence. Children can change in their behaviour and their personality as they grow older. It can be difficult to tell whether such changes are caused by the brain injury or represent, for example, the teenage years.

These challenges may mean that the extent of the brain injury may not be clearly evident until the child is in their late teens or later. In addition, the child will have been supported by the family unit when they are growing up. Whether the injury may, for example, affect their ability to live independently will sometimes not be clear they leave the family home.

It is for this reason that children who have sustained a brain injury should usually be advised not to settle their claim before adulthood. This is the child’s only opportunity to be compensated for the effects of the injury and the family should not feel under pressure to settle the claim too early until the extent of the injury is understood. In any event, no settlement involving a child can be accepted without the court’s approval and the judge will be reluctant to give such approval until satisfied that the full severity, including any long-term implications, of the injury is known.