Children and parents frequently report a variety of symptoms following mild closed-head injuries (CHI). These post-concussive symptoms often occur in the absence of any objective evidence of brain trauma and despite substantial recovery on standardized cognitive testing. Debate therefore continues regarding the determinants and consequences of post-concussive symptoms following mild CHI.
The specific aims of the proposed study are to examine the (1) natural history, (2) prediction, and (3) consequences of post-concussive symptoms in children with mild CHI. The study will involve 200 8 to 15 year old children with mild CHI and 100 with mild orthopedic injuries not involving the head in a concurrent cohort/prospective research design. The children and their families will be assessed four times during the first year post-injury (i.e., at 1 week, 1 month, 3 months, and 12 months post-injury). Post-concussive symptoms will be assessed using rating scales and interviews, with both children and parents as informants. Predictors of post-concussive symptoms will include injury characteristics, cognitive abilities, and non-injury related child and family variables. Outcomes to be assessed include school performance, health utilization, and other aspects of child and family functioning. The study will examine three major hypotheses: (1) Children with mild CHI will display more post-concussive symptoms than children with mild orthopedic injuries, although group differences in incidence are expected to vary as a function of symptom type and time since injury; (2) The incidence of post-concussive symptoms will be related to (a) injury characteristics, (b) the extent to which the injury results in impairment in cognitive performance, and (c) non-injury related child and family factors. These relationships again are expected to vary as a function of symptom type and time since injury; and (3) Severe post-concussive symptoms will be associated with more child disability. The study will result in a clearer understanding of the roles that injury characteristics, post-injury cognitive status, and non-injury related factors play in the onset and persistence of post-concussive symptoms following mild CHI in children and adolescents. The study also will provide insights into the functional consequences of those symptoms for children. The findings will help resolve the scientific controversy regarding the outcomes associated with mild CHI, and will assist physicians and other health care providers in identifying the sequelae of mild CHI and managing them effectively.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
1R01HD039834-01
Application #
6232513
Study Section
Special Emphasis Panel (ZRG1-BBBP-6 (01))
Program Officer
Quatrano, Louis A
Project Start
2001-05-24
Project End
2006-04-30
Budget Start
2001-05-24
Budget End
2002-04-30
Support Year
1
Fiscal Year
2001
Total Cost
$750,003
Indirect Cost
Name
Nationwide Children's Hospital
Department
Type
DUNS #
147212963
City
Columbus
State
OH
Country
United States
Zip Code
43205
Taylor, H Gerry; Orchinik, Leah J; Minich, Nori et al. (2015) Symptoms of Persistent Behavior Problems in Children With Mild Traumatic Brain Injury. J Head Trauma Rehabil 30:302-10
McNally, Kelly A; Bangert, Barbara; Dietrich, Ann et al. (2013) Injury versus noninjury factors as predictors of postconcussive symptoms following mild traumatic brain injury in children. Neuropsychology 27:1-12
Moran, Lisa M; Taylor, H Gerry; Rusin, Jerome et al. (2012) Quality of life in pediatric mild traumatic brain injury and its relationship to postconcussive symptoms. J Pediatr Psychol 37:736-44
Yeates, Keith Owen; Kaizar, Eloise; Rusin, Jerome et al. (2012) Reliable change in postconcussive symptoms and its functional consequences among children with mild traumatic brain injury. Arch Pediatr Adolesc Med 166:615-22
Yeates, Keith Owen; Taylor, H Gerry; Rusin, Jerome et al. (2012) Premorbid child and family functioning as predictors of post-concussive symptoms in children with mild traumatic brain injuries. Int J Dev Neurosci 30:231-7
Moran, Lisa M; Taylor, H Gerry; Rusin, Jerome et al. (2011) Do postconcussive symptoms discriminate injury severity in pediatric mild traumatic brain injury? J Head Trauma Rehabil 26:348-54
Woodrome, Stacey E; Yeates, Keith Owen; Taylor, H Gerry et al. (2011) Coping strategies as a predictor of post-concussive symptoms in children with mild traumatic brain injury versus mild orthopedic injury. J Int Neuropsychol Soc 17:317-26
Hajek, Christine A; Yeates, Keith Owen; Taylor, H Gerry et al. (2011) Agreement between parents and children on ratings of post-concussive symptoms following mild traumatic brain injury. Child Neuropsychol 17:17-33
Taylor, H Gerry; Dietrich, Ann; Nuss, Kathryn et al. (2010) Post-concussive symptoms in children with mild traumatic brain injury. Neuropsychology 24:148-59
Yeates, Keith Owen (2010) Mild traumatic brain injury and postconcussive symptoms in children and adolescents. J Int Neuropsychol Soc 16:953-60

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