Tuesday, August 11, 2015

Pre-Injury Behavioral Status Linked to Recovery From Mild TBI in Children

Children who report lingering postconcussive problems after sustaining a mild traumatic brain injury (TBI) are rated by their parents as having more pre-injury anxiety than national norms, according to a report in The Journal of Neuropsychiatry and Clinical Neurosciences in Advance. The findings suggest providers should carefully consider pre-injury emotional-behavioral functioning when treating children with persistent problems after a mild TBI.

Researchers from the Department of Physical Medicine and Rehabilitation at the University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, surveyed the parents of 278 children (8 to 17 years old) who reported lingering problems following a mild TBI. The parents were asked to rate their children’s pre-injury emotional-behavioral functioning using the Behavior Assessment System for Children–Second Edition (BASC-2), an instrument designed to assess childhood psychopathology and behavioral disorders.

The researchers found that the rates of pre-injury anxiety in children were statistically elevated compared with national norms. They also found that children rated as having clinically significant externalizing problems before the presenting injury had sustained, on average, nearly twice as many previous mild TBIs compared with children with normal-range externalizing problems.

“From a clinical standpoint, our results suggest that providers should carefully consider pre-injury emotional-behavioral functioning when evaluating and managing children with persistent problems after a mild TBI. … Such children are likely to benefit most from reassurance from a brain injury perspective, along with cognitive-behavioral treatment focused on stress reduction, pain management, and positive coping strategies,” the study authors stated. “On the basis of our findings, we also speculate that children with clinically significant anxiety might particularly benefit from psychoeducation immediately after a mild TBI and that targeted early interventions (such as relaxation training) could possibly help prevent the development of persistent postconcussive complaints in this population.”
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