Premorbid child and family functioning as predictors of post-concussive symptoms in children with mild traumatic brain injuries

Int J Dev Neurosci. 2012 May;30(3):231-7. doi: 10.1016/j.ijdevneu.2011.05.008. Epub 2011 May 27.


Study aim: This study sought to determine whether premorbid child and family functioning accounts for or moderates group differences in post-concussive symptoms following mild traumatic brain injury (TBI) in childhood.

Methods: This prospective, longitudinal cohort study recruited 8- to 15-year-old children, 186 with mild TBI and 99 with orthopedic injuries (OI), from consecutive emergency department admissions. Parents and children rated post-concussive symptoms within 3 weeks of injury and at 1, 3, and 12 months post injury. Parents also provided retrospective ratings of pre-injury symptoms, as well as of premorbid child behavioral adjustment, overall family functioning, and other stressors and resources in the family environment.

Results: Children with mild TBI reported more post-concussive symptoms than those with OI, as did their parents, although premorbid child behavioral adjustment and symptoms also were significant predictors of post-concussive symptoms. Group differences in somatic symptoms as reported by parents were more pronounced among children from families that were higher functioning and had more environmental resources.

Discussion: Mild TBI during childhood results in more post-concussive symptoms than OI, even after children's premorbid adjustment is taken into account. Counter to expectations, post-concussive symptoms following mild TBI may actually be more apparent among children from higher-functioning families with greater resources.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Brain Concussion / epidemiology*
  • Child
  • Cognition Disorders / epidemiology*
  • Comorbidity
  • Family Relations*
  • Female
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Ohio / epidemiology
  • Prevalence
  • Prognosis
  • Young Adult