Predictors of child post-concussion symptoms at 6 and 18 months following mild traumatic brain injury

Background: A proportion of children will experience persistent post-concussion symptoms (PCS) following a mild traumatic brain injury (mTBI). As persistent PCS may be maintained by pathological and psychological factors, this study aimed to describe and evaluate potential pre- and post-injury parent and child predictors of persistent PCS. Methods: A total of 150 children with mTBI and their parents participated. Parents completed measures of their own distress and children's PCS and health-related quality-of-life (HRQoL) at baseline (reflecting pre-injury function). These measures, as well as measures of children's distress and cognitive function were administered at 6 and 18 months post-injury. Results: Children's PCS at 6 months post-injury were predicted by both pre-injury parent distress and children's pre-injury PCS. At 18 months post-injury, children's PCS were predicted by higher levels of parent distress and child PCS at 6 months post-injury, as well as poorer post-injury cognitive functioning. Change in PCS between 6-18 months post-injury was predicted by parent's pre-injury anxiety and children's HRQoL. Conclusions: Children at risk of persistent PCS can be identified by higher levels of pre- and post-injury PCS, parent distress and poorer post-injury cognition. These factors should be addressed by interventions aimed at minimizing the occurrence and impact of child PCS.