Discrepancies in child and parent reporting of concussion symptoms

ABSTRACT

Objective: To assess discrepancies between child and parent symptom reports following concussion.

Methods: Prospective cohort study involving 61 patients, age 7–21 years, diagnosed with a concussion within the previous 14 days. Children/parents completed the Child SCAT-3 symptom inventory at enrollment and 4 weeks post-injury. A within-subjects t-test was used to compare differences in child/parent response for each of 20 individual symptoms, 4 symptom domains, and total symptom severity. Pearson correlations were used to measure agreement between child/parent responses. A repeated measures analysis of variance assessed the effect of time on child/parent symptom discrepancy.

Results: At enrollment, children reported higher symptom severity for ‘distracted easily’ (adj. p = .015) and ‘confused’ (adj. p = .015). There was moderate-to-high (r > 0.3) agreement between children and parents for more individual symptoms at enrollment (18/20) than at 4 weeks post-injury (14/20). Age had no effect (p > .05) on the discrepancy between child/parent reports.

Conclusions: Although there was moderate-to-strong agreement between child/parent reports of concussion symptoms, discrepancies in individual cognitive symptom reports exist, in both children and adolescents. Therefore, collection of parent scales may provide useful information when tracking cognitive symptoms in adolescent patients, who may under-report or under-recognize cognitive deficits.

KEYWORDS:

• Mild traumatic brain injury
• scales
• youth
• pediatric
• SCAT

Acknowledgments

We thank Andrea Loeffert DO, Robert Olympia MD, and Harry Bramley DO for assistance with participant identification. We thank Jennifer Stokes, Jeremiah Johnson, and Molly Carney for assistance with data collection, and Jessica Bieler for aiding in study design.

Disclosure

Steven Hicks serves as a paid consultant and scientific advisory board member for Quadrant Biosciences, Inc. He is named as a co-inventor on intellectual property involving the use of ribonucleic acid technology for concussion prognosis. These conflicts of interest are unrelated to the authorship, and/or publication of this article. Ruikang Liu receives no financial benefits from any organizations and has no potential conflicts of interest with respect to this research. This study was funded by the Children’s Miracle Network. Dr. Hicks’ effort was supported by the National Center for Advancing Translational Sciences, Grant KL2 TR002015 and Grant UL1 TR002014. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Additional information

Funding

This study was funded by the Children's Miracle Network, the Gerber Foundation [ID#5295], and the National Center for Advancing Translational Sciences [KL2 TR002015, UL1 TR002014].