Evaluation of a follow-up program for mild traumatic brain injury in schoolchildren.

INTRODUCTION: Mild traumatic brain injury is a common condition in childhood. Although classified as mild, post-concussive symptoms may persist and interfere with daily activities. Because no established guidelines exist with respect to follow-up medical care for these children, there may be a delay in receiving appropriate care. We developed a follow up program to screen for persistent symptoms and if necessary, refer patients for further medical assistance. METHODS: From July 2010 until December 2013, eligible children aged 4-18 years who presented after sustaining a mild traumatic brain injury were included. All patients received a phone call after 6 weeks. After a period of 3 months, both their schoolteacher and parents were asked to complete in a questionnaire. The results were discussed monthly by a multidisciplinary team. RESULTS: A total of 305 children were enrolled in our follow-up program. Headache was the most common acute symptom upon presentation (63%). Overall, 19% of all patients had problems, either at 6 weeks or 3 months. 14% of these patients were referred for special care. Most common persistent post-concussive symptoms were headache (32%), cognitive problems (23%) and behavioural problems (16%). After a period of two years, a review of patient charts revealed that all of the problems were resolved. CONCLUSION: One fifth of the children exhibit post-concussive symptoms after mild traumatic brain injury. Education of patients and caregivers and a follow up visit if needed applied appropriate care at an early stage to minimise physical and mental problems.

Test/retest reliability and inter-rater agreement of the Quality of Upper Extremities Skills Test (QUEST) for older children with acquired brain injuries.

Test/retest reliability and inter-rater agreement was established on the Quality of Upper Extremities Skills Test (QUEST) for 16 children between 6 and 16 years of age who had an acquired brain injury. Performance on the QUEST was videotaped for the purpose of scoring, and some modifications were made to the administration and scoring of the assessment. Intra-class correlation indicated high agreement for test/retest reliability (0.90 to 0.95), and inter-rater reliability (0.84 to 0.94) across all subtests. The findings are discussed in terms of ongoing test refinements and the extension of the original age range and diagnostic group for which the test was designed.