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Yumul JN, McKinlay A, Anderson V, Catroppa C. Behaviour outcomes three months after mild TBI in preschool children. Neuropsychol Rehabil 2024; 34:600-618. [PMID: 37354534 DOI: 10.1080/09602011.2023.2224030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 06/02/2023] [Indexed: 06/26/2023]
Abstract
This study examined parents' report of behaviour in preschoolers after a mild traumatic brain injury (mTBI), compared the proportion of preschoolers with elevated behaviour ratings between the mTBI and limb injury (LI) groups, and explored injury, premorbid child, and parent variables that may be associated with parents' report of behaviour at three months post-injury. Children aged 2-5 years with a mTBI (n = 13) or mild LI (n = 6) were recruited from the emergency department. Behaviour was assessed using the Child Behaviour Checklist. Preliminary findings showed that post-injury behaviour ratings remained in the normal range. The mTBI group had higher scores than the LI group at three months post-injury in terms of sleep; however, this may have been pre-existing. Two children with mTBI received borderline-clinically significant ratings on diagnostic-level anxiety problems at the three-month follow-up, while none of the limb-injured controls obtained elevated behaviour ratings. Parent-rated post-injury behaviour was significantly associated with premorbid child functioning and parental stress, which needs to be explored in greater detail using larger preschool mTBI samples.
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Affiliation(s)
- Joy Noelle Yumul
- Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Audrey McKinlay
- Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Vicki Anderson
- Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- The Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Cathy Catroppa
- Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- The Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
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Yumul JN, Catroppa C, McKinlay A, Anderson V. Post-Concussive Symptoms in Preschool Children up to Three Months Post-Injury. Dev Neurorehabil 2023; 26:338-347. [PMID: 37548355 DOI: 10.1080/17518423.2023.2242945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 06/20/2023] [Accepted: 07/26/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND AND AIMS Post-concussive symptoms (PCS) are central to the assessment and management of mild traumatic brain injury (mTBI); however, this remains poorly understood in children aged ≤5 years. The study aimed to explore individual PCS, pattern of parents' PCS report over time, proportion of symptomatic children, and variables associated with parents' report of PCS in their preschool child after a mTBI. METHODS Children aged 2-5 years with either a mTBI (n=13) or limb injury (n=6) were recruited from the emergency department (ED). Parent ratings of child PCS were assessed at ED presentation, at one month, and at three months post-injury. Injury (e.g. injury group, pain), child (e.g. pre-existing behavior, symptoms), and parent (e.g. parental stress, education) characteristics were considered when investigating variables that may be relevant to parent report of PCS. RESULTS The number of total, physical, and sleep PCS were significantly higher after mTBI, with a significant decrease in physical and sleep PCS over time. The proportion of symptomatic children was comparable between injury groups at each time point. Acute pain and pre-injury symptoms were significantly associated with parents' acute PCS report in the mTBI group. Further research is needed on variables that may be relevant to parents' PCS report at follow-up. CONCLUSION Preliminary findings suggest a general trauma response after a mTBI or limb injury, but acute physical and sleep PCS may help differentiate the injury groups. Injury and premorbid child variables may be relevant to parents' report of acute PCS in their child. Additional research is needed to investigate PCS in preschoolers and variables that may predict parents' PCS report.
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Affiliation(s)
- Joy Noelle Yumul
- Murdoch Children's Research Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | - Cathy Catroppa
- Murdoch Children's Research Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
- The Royal Children's Hospital, Melbourne, Australia
| | - Audrey McKinlay
- Murdoch Children's Research Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
- University of Canterbury, Christchurch, New Zealand
| | - Vicki Anderson
- Murdoch Children's Research Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
- The Royal Children's Hospital, Melbourne, Australia
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Singh S, Hoch JS, Hearps S, Dalziel K, Cheek JA, Holmes J, Anderson V, Kuppermann N, Babl FE. Sports-related traumatic brain injuries and acute care costs in children. BMJ Paediatr Open 2023; 7:10.1136/bmjpo-2022-001723. [PMID: 36720502 PMCID: PMC9890755 DOI: 10.1136/bmjpo-2022-001723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/17/2022] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE To estimate traumatic brain injuries (TBIs) and acute care costs due to sports activities. METHODS A planned secondary analysis of 7799 children from 5 years old to <18 years old with head injuries enrolled in a prospective multicentre study between 2011 and 2014. Sports-related TBIs were identified by the epidemiology codes for activity, place and injury mechanism. The sports cohort was stratified into two age groups (younger: 5-11 and older: 12-17 years). Acute care costs from the publicly funded Australian health system perspective are presented in 2018 pound sterling (£). RESULTS There were 2903 children (37%) with sports-related TBIs. Mean age was 12.0 years (95% CI 11.9 to 12.1 years); 78% were male. Bicycle riding was associated with the most TBIs (14%), with mean per-patient costs of £802 (95% CI £644 to £960) and 17% of acute costs. The highest acute costs (21%) were from motorcycle-related TBIs (3.8% of injuries), with mean per-patient costs of £3795 (95% CI £1850 to £5739). For younger boys and girls, bicycle riding was associated with the highest TBIs and total costs; however, the mean per-patient costs were highest for motorcycle and horse riding, respectively. For older boys, rugby was associated with the most TBIs. However, motorcycle riding had the highest total and mean per-patient acute costs. For older girls, horse riding was associated with the most TBIs and highest total acute costs, and motorcycle riding was associated with the highest mean per-patient costs. CONCLUSION Injury prevention strategies should focus on age-related and sex-related sports activities to reduce the burden of TBIs in children. TRIAL REGISTRATION NUMBER ACTRN12614000463673.
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Affiliation(s)
- Sonia Singh
- Department of Paediatrics, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia .,Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Jeffrey S Hoch
- Center for Healthcare Policy and Research, University of California Davis Health System, Sacramento, California, USA.,Department of Public Health Sciences, University of California, Davis, California, USA
| | - Stephen Hearps
- Child Neuropsychology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Kim Dalziel
- Centre for Health Policy, The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
| | - John Alexander Cheek
- Emergency Department, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - James Holmes
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA
| | - Vicki Anderson
- Clinical Sciences Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Nathan Kuppermann
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California, USA.,Department of Pediatrics, University of California Davis School of Medicine, Sacramento, California, USA
| | - Franz E Babl
- Department of Paediatrics, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia.,Emergency Department, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
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