This autism analysis case involves brain trauma of a high functioning adolescent on the autism spectrum, as a result of a high-speed head-on automobile crash in Alaska. The child was attending school for developmentally challenged students, and part of her accommodations include transport from her home to the school. One day when he was coming home, for reasons still not certain, the van crossed the center-line of the road and collided head-on into an oncoming truck. Both vehicles were moving at a speed of 45-50MPH. The school van was crushed, killing the driver instantly. The child was trapped in his school van next to a grotesquely deformed dead driver who she regarded as a friend after having driven with her to school for approximately five times a week for the previous year.
He was trapped for approximately 31 minutes before emergency responders could get him out of the van. He was described during that time as hysterical and inconsolable by the witnesses that have been interviewed. He has displayed and continues to display obsessive behaviors regarding the occurrence. The initial damages include a broken collarbone as the principal orthopedic injury, and in addition, he has sustained a traumatic brain injury with resulting post traumatic encephalopathy, and post traumatic stress disorder as diagnosed by his treating pediatric neurologist, his developmental pediatrician, and his neuro-psychologist. In addition, there has been a documented loss of scholastic achievement in the years after the crash, once described as a loss of as much as three grade levels. The child has recovered academically to some extent since that time, however his academic trajectories are not what they were before the accident.
Additionally there are reports that document a significant post-accident exacerbation in the underlying autistic behaviors, particularly those which prevent more effective human interaction (behaviors of the type that will limit her economic horizons/employability). The child’s control over his autistic behaviors have not returned to pre-accident state.
Question(s) For Expert Witness
1. Are you able to address the causation of damage, which inherently entails segregating the losses that flow from the traumatic brain injury as opposed to the underlying autism?
2. To a reasonable degree of medical certainty, are you able to assess to what extent the child’s injuries may impair her ongoing academic and vocational development, and whether such impairment is permanent?
Expert Witness Response E-007475
I believe I would be able to confidently assess the relative contribution traumatic brain injury and related injury due to the temporal nature of any disability or change in scholastic achievement following the crash. Certainly, the injury itself, the post-traumatic encephalopathy, and post-traumatic stress can all contribute to ongoing problems following the injury.
I currently teach on the biomarker outcome predictors in the pediatric emergency department for traumatic brain injury. I have been published numerous times on pediatric traumatic brain injury, and have received a half a million dollar grant from the National Center for Injury Prevention and Control for my work on characterizing the short and long term consequences of traumatic brain injury among children in the United States.
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