Objectives: Infants and children who sustain a brain injury under the age of 5 are particularly vulnerable to the effects of acquired global brain injuries (Eiselle & Aram, 1993, Ewing-Cobbs & Barnes, 2003; Ewing-Cobbs & Barnes, 2002, Lowenthal, 1998). Contrary to theories on neuroplasticity, a brain injury in preschool creates risks for developmental consequences that can remain with a child across their lifespan and create consequences as an adult. The goal of this paper is to describe an injury reporting system in the state of Georgia with comparison to the incidence reported in school programs.

Method: Research on the impact of the injury on the child and family function will be reviewed and offered as evidence for the types of services needed for this population. A description of Central Registry statistics in the state of Georgia will be compared to those children identified in preschool special education programs will be offered. Discrepancies in reporting and suggested causes will be highlighted.

Results: In 2004, 7,922 visits to the emergency room were reported for children between the ages of 0-4 years and of these children, 7,763 were discharged home for care. In the same year, 16 children with TBI were served in special education, a number that increased to 17 for 2005. Findings of reporting discrepancies for preschool children in Georgia concur with the recent report on under-identification of school-aged children following TBI (Todis, 2007). This age group has a high risk for continued consequences without a single point of entry into follow-up services following discharge from medical care.