Parent and child ratings of child behaviour following mild traumatic brain injury

ABSTRACT

Background: Mild traumatic brain injury (mTBI) in children is most commonly associated with parent-reported child behaviour problems. The extent to which parent and child ratings align is unknown.

Objectives: To examine differences in child behaviour and patterns of recovery over the first 12 months following mTBI based on parent and child self-report.

Methods: Ninety-nine children (8–15 years) with mTBI and one of their parents completed the Behavioural Assessment Scale for Children – version 2 to assess child hyperactivity, anxiety and depression at baseline, 1, 6 and 12 months post-injury. Differences between ratings from parents and children were evaluated using Bland–Altman limits of agreement analyses. Child recovery over time was examined using mixed models repeated measures analyses.

Results: Parent and child ratings for child hyperactivity, anxiety and depression differed significantly at baseline and these differences remained constant at each follow-up. Parents tended to report more child hyperactivity, anxiety and depression. Over time, parents and children reported fewer child hyperactivity and anxiety problems.

Conclusions: Parents and children have poor agreement in ratings of child behaviour yet there is general agreement in patterns of recovery in the year following mTBI. Findings show the importance of considering both parent and self-report of child behaviour.

KEYWORDS:

• Traumatic brain injury
• behaviour
• children
• mild brain injury

BIONIC study group members

Steering committee: New Zealand V Feigin (Chair and Principal investigator), S Barker-Collo, K McPherson, A Theadom, K Jones, A Jones, B Te Ao (Auckland University of Technology); R Kydd, P Alan Barber, V Parag, S Ameratunga (University of Auckland); N Starkey (Waikato University); A Dowell (Otago University); M Kahan, G Christey (Waikato District Health Board); N Hardaker (Accident Compensation Corporation), USA P Brown (University of California). Diagnostic adjudication group: New Zealand V Feigin, S Barker-Collo (Auckland University of Technology), M Kahan (Waikato District Health Board). Maori, Pacific, and Asian study consultants: New Zealand B Te Ao, P Fairbairn-Dunlop (Auckland University of Technology); A Sobrun-Maharaj (University of Auckland); J Hapuku (Waikato District Health Board); K De Silva (Counties Manukau District Health Board).

Acknowledgments

We are indebted to the research team for their dedication and performance. A list of members of the BIONIC team is available at www.nisan.aut.ac.nz. Most importantly, special thanks to participating children and their families for their time and support of this research.

Declaration of Interest

The authors report no declarations of interest.

Additional information

Funding

This research was funded by the Health Research Council of New Zealand under grant numbers HRC 09/063A and HRC 13/408. The funding for this study was awarded before Kathryn McPherson became Chief Executive of the Health Research Council of New Zealand and she had no influence on the funding decision.