In paediatric brain injury claims, early recovery, normal imaging and positive primary school reports can create false reassurance. Yet some of the most serious consequences only emerge later, when developmental demands increase and executive function is expected to operate independently.

In this webinar, Dr Nigel Colbert and Hylton Armstrong explore how subtle neuropsychological deficits present in children, why they are often missed in early years, and how neuropsychological evidence can strengthen or undermine causation and prognosis in personal injury and clinical negligence litigation. The discussion focuses on delayed emergence, the limits of conventional imaging, the role of psychometric testing, and the practical risks of premature prognosis.

About the Speakers

Dr Nigel Colbert

Consultant Clinical Paediatric Neuropsychologist and Expert Witness

Dr Nigel Colbert is a Consultant Clinical Paediatric Neuropsychologist with over ten years of medico legal experience and more than two decades working in community based neurorehabilitation. He is registered on the British Psychological Society Specialist Register of Clinical Neuropsychologists and is regularly instructed in cases involving acquired brain injury, cerebral palsy and complex developmental presentations.

His medico legal work focuses on developmental trajectory, educational and functional outcome, and the interpretation of psychometric evidence in the context of paediatric brain injury.

Hylton Armstrong

Barrister, Parklane Plowden Chambers

Hylton Armstrong is a barrister specialising in personal injury and clinical negligence claims, acting for both claimants and defendants in serious and high value matters. He has extensive experience in cases involving children with neuropsychological injury and the evidential challenges that arise where impairment is subtle, delayed or disputed.

Key Themes

In this session, Dr Colbert and Hylton Armstrong explore:

• Paediatric brain injury cases being assessed through an adult lens
• Why primary school performance can mask emerging impairment
• The sleeper effect and delayed executive dysfunction at secondary school transition
• What conventional imaging can and cannot show in subtle cases
• How psychometric testing should be selected, interpreted and contextualised
• Causation challenges in developing brains, including pre existing vulnerability and reduced reserve
• Common evidential pitfalls, including overreach, inappropriate measures and premature prognosis
• What makes a strong medico legal neuropsychology report, and where experts feel most vulnerable to criticism
  
  

Medico Legal Insights

1. Normal imaging does not rule out meaningful neuropsychological impairment, particularly where network disruption affects function rather than structure.
2. Early reports can be misleading because primary school environments scaffold executive demand, allowing children to compensate until secondary school transition.
3. Psychometric testing is essential, but the qualitative interpretation of how a child approaches tasks can be as informative as scores.
4. Causation in paediatric neuropsychology is rarely linear and must be grounded in developmental literature, trajectory and context rather than reductionistic anatomy.
5. Pre existing neurodevelopmental difficulties do not automatically negate causation, but may reduce cognitive reserve and resilience following injury.
6. A good report does not just list results. It builds a coherent model of the child in their environment and projects a defensible developmental pathway.
   
   

Read the full medico legal article here →