Agreement between Parents and Children on Ratings of Post-Concussive Symptoms Following Mild Traumatic Brain Injury

Abstract

The level of parent-child agreement on post-concussive symptoms (PCS) was examined in children following mild traumatic brain injuries (TBI). As part of a larger longitudinal study, 186 children with mild TBI and 99 with orthopedic injuries (OI), from 8 to 15 years of age, were recruited prospectively. Parents and children completed the PCS Interview (PCS-I) and the Health and Behavior Inventory (HBI) at 2 weeks, 1 month, 3 months, and 12 months postinjury. Item-level correlations between child and parent ratings on both measures of PCS were significant but modest in both groups. Parent-child correlations for composite scales on the HBI and the total score on the PCS-I were significant in both groups, but somewhat higher in the OI group than in the mild TBI group. Mean symptom ratings tended to be significantly higher for children as compared to parents, especially for somatic symptoms. Parents and children display modest agreement when reporting PCS; their ratings correlate significantly, but children report higher mean levels of symptoms than parents.

Keywords:

• Head injury
• Post-concussion syndrome
• Interrater agreement
• Correlational agreement
• Outcome

The larger study on which the research was based was supported by grants R01 HD39834 and K02 HD44099 from the National Institute of Child Health and Human Development and the National Center for Medical Rehabilitation Research to Keith Owen Yeates. The authors wish to acknowledge the contributions of Lauren Ayr, Anne Birnbaum, Amy Clemens, Taryn Fay, Kalaichelvi Ganesalingham, Amanda Lininger, Melissa Ginn, Katie Pestro, Elizabeth Roth, Elizabeth Shaver, and Heidi Walker in conducting the study. Portions of the research were presented at the annual meeting of the International Neuropsychological Society in Atlanta, GA, February 2009.