Objective: In 2018, the Centers for Disease Control Prevention (CDC) published an evidence-based guideline on the diagnosis and management of mild traumatic brain injury (mTBI) among children. This commentary summarizes the key recommendations in the CDC Pediatric mTBI Guideline most relevant for neuropsychologists and discusses research gaps and topics that should receive attention in future iterations of the Guideline.Method: We described the methods used to develop the Guideline, which included a comprehensive Systematic Review. We also distilled and presented key practice strategies reflected in Guideline.Results: To optimize care of pediatric patients with mTBI, neuropsychologists should: use validated, age-appropriate symptom scales, assess evidence-based risk factors for prolonged recovery, provide patients with instructions on return to activity customized to their symptoms, and counsel patients to return gradually to nonsports activities after a short period of rest. Future iterations of the Guideline should encompass a review and guidance on care of patients with psychiatric and psychological difficulties, as well as the potential use of imaging to assess patients with persistent symptoms. Expanded research on mTBI among girls, children age 8 and under, and effective treatments for pediatric mTBI will be beneficial to inform care practices.Conclusions: Recommendations in the CDC Pediatric mTBI Guideline highlight multiple opportunities for neuropsychologists to take action to improve the care of young patients with mTBI and to advance research in the field. Multiple resources and tools are available to support implementation of these recommendations into clinical practice.
Keywords: Brain; TBI; concussion; guideline; injury.
CDC's guideline on pediatric mild traumatic brain injury: Recommendations for neurologists.Neurol Clin Pract. 2019 Jun;9(3):241-249. doi: 10.1212/CPJ.0000000000000624. Neurol Clin Pract. 2019. PMID: 31341712 Review.
Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children.JAMA Pediatr. 2018 Nov 1;172(11):e182853. doi: 10.1001/jamapediatrics.2018.2853. Epub 2018 Nov 5. JAMA Pediatr. 2018. PMID: 30193284 Free PMC article.
Seeking to improve care for young patients: Development of tools to support the implementation of the CDC Pediatric mTBI Guideline.J Safety Res. 2018 Dec;67:203-209. doi: 10.1016/j.jsr.2018.09.006. Epub 2018 Oct 1. J Safety Res. 2018. PMID: 30553425 Free PMC article.
CDC Guideline on Mild Traumatic Brain Injury in Children: Important Practice Takeaways for Sports Medicine Providers.Clin J Sport Med. 2018 Nov 22:10.1097/JSM.0000000000000704. doi: 10.1097/JSM.0000000000000704. Online ahead of print. Clin J Sport Med. 2018. PMID: 30489330
Animal Models for Concussion: Molecular and Cognitive Assessments—Relevance to Sport and Military Concussions.In: Kobeissy FH, editor. Brain Neurotrauma: Molecular, Neuropsychological, and Rehabilitation Aspects. Boca Raton (FL): CRC Press/Taylor & Francis; 2015. Chapter 46. Brain Neurotrauma: Molecular, Neuropsychological, and Rehabilitation Aspects. 2015. PMID: 26269898 Free Books & Documents. Review.