The PARENT model: a pathway approach for understanding parents’ role after early childhood mild traumatic brain injury

Abstract

Objective

Mild traumatic brain injury (mTBI or “concussion”) is a highly prevalent health condition in children, and those under the age of 6 years have the highest rate of Emergency Department presentation for suspected head injuries. The outcome of mTBI is determined by a range of child (injury, biological, functional) and environmental (socio-economic status, parent, family) factors. The aim of this work is to present evidence supporting the central role of parental and familial factors in pediatric mTBI recovery, and to illustrate ways in which parental factors can especially influence the outcome of early mTBI, defined as injuries sustained by infants, toddlers and preschoolers.

Method

The manuscript first presents a topical review of empirical studies providing evidence that family functioning and parental factors such as their mental or affective state, parenting style, and the quality of their interactions with their child, are affected by and determine the course of recovery after pediatric mTBI. Then, a pathway approach and conceptual model are proposed to illustrate probable scenarios associated with how parents detect and react to their child’s post-concussive symptoms and changes in behavior after early mTBI.

Conclusion

The “Perception, Attribution, and Response after Early Non-inflicted Traumatic Brain Injury” (PARENT) model suggests that parental roles and factors are especially influential in the context of early brain injuries, and that parents’ ability to perceive, attribute and respond to the symptoms experienced by their child in a well-adjusted and adaptive manner critically sets the direction and rhythm of the early mTBI recovery process.

KEYWORDS:

• Traumatic brain injury
• concussion
• early childhood
• parent
• parent-child interactions
• mental health
• model
• predictors
• behavior
• post-concussive symptoms

Acknowledgments

We would like to thank the entire LION Project team for their contribution to the work that shaped the ideas in this manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The article is a conceptual review and does not include empirical data.

Additional information

Funding

This work was supported by grants from the Canadian Institutes of Health Research.