Agreement between parent reported and child self-reported sport-related concussion history: A brief report

Association of concussion/brain injury symptoms and diagnosis with mental and social well-being in 2020 National Health Interview Survey (NHIS) children

BACKGROUND

Population-based data regarding the associations between prior concussion or brain injury symptoms/diagnosis and mental/social well-being is lacking for U.S. children.

METHODS

Associations between prior concussion or brain injury symptoms/diagnosis (reported by parents of children ages 5-17 from the 2020 National Health Interview Survey) and current mental/social well-being were determined in multivariable models.

RESULTS

Amongst 2020 US children, 8.7% and 5.3% had previous symptoms and diagnosis of concussion/brain injury, respectively. 23% of children with symptoms were never checked for a concussion/brain injury, with younger children at higher risk of not getting checked after symptomatic head trauma. Prior concussion or brain injury symptoms/diagnosis was associated with a higher likelihood of current depressive symptoms (odds ratio [OR] = 1.60; 95% CI = 1.21-2.14; p < 0.001), anxiety (OR = 2.07; 95% CI = 1.52-2.82; p < 0.001), difficulty making friends (OR = 1.57; 95% = 1.06-2.33; p = 0.03), use of medications for mental/social/behavioral issues (OR = 1.69; CI = 1.21-2.36; p = 0.002), and mental health therapy/counseling (OR = 1.52; 95% CI = 1.13-2.04; p = 0.006).

CONCLUSION

U.S. children with prior concussion or brain injury symptoms/diagnosis have a higher rate of mental and social disturbances and a more frequent need for mental health services. Nearly one-quarter of children with significant symptoms after head trauma are never checked for a concussion/brain injury; routine concussion evaluation after head trauma should be emphasized especially in younger children.

Concussion Nondisclosure in Youth Sports

CONTEXT

Studies regarding sport-related concussion (SRC) reporting behaviors and reasons for nondisclosure primarily focus on older athletic populations. Youth athletes participating in contact sports are also at risk for SRC; however, little is known about their SRC disclosure patterns and reasons for nondisclosure.

OBJECTIVE

To examine self-reported SRC history and reasons for SRC nondisclosure of youth athletes ages 8-14 years.

DESIGN

Cross-sectional study.

SETTING

Youth athletes in organized football, ice hockey, lacrosse, and soccer.

PATIENTS OR OTHER PARTICIPANTS

411 youth athletes (male: 70.0% (n=287/410); median age: 11 (IQR 10-13) years).

MAIN OUTCOME MEASURES

A 15-minute survey including self-reported demographics, diagnosed and non-disclosed SRC history, and reasons for nondisclosure of suspected SRCs.

RESULTS

Ten percent of respondents (n=41/411) recounted one or more diagnosed SRC; 12.7% (n = 52/411) did not report a suspected SRC, and 13.1% (n = 53/404) indicated they continued to practice and 12.3% (n = 50/425) reported they continued to play in a game after a suspected SRC. Significant associations between sport and nondisclosure exisited (p < .001), but not self-reported concussion history (p = .14). In sex comparable analyses boys lacrosse players had higher frequency of nondisclosure compared to girls (p = .05). Most common reasons for nondisclosure were not wanting to lose playing time 66.7% (n=32/48), miss a game 56.3% (n=27/48), and let the team down 43.8% (n=21/48); and uncertainty over injury severity and presence of SRC 43.8% (n=21/48).

CONCLUSIONS

Ten percent of youth athletes self-reported at least one diagnosed SRC. However, youth athletes also report continuing to practice or play within a game after a suspected SRC. Reasons for nondisclosure at this age are similar to those reported in high school and college athletes. Recent research suggests negative consequences of continued play with SRC, especially in acute stages. Future educational initiatives should emphasize these risks, and focus on reasons why athletes of both sexes withhold reporting.