Predicting outcome after childhood brain injury: Figure 1:

Forsyth, Rob; Kirkham, Fenella J.

doi:10.1503/cmaj.111045

Cited by 44 publications

(39 citation statements)

References 106 publications

(92 reference statements)

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“…The complexity and multi‐determinism of social competence (Beauchamp, ) may explain why this domain is vulnerable even to mTBI and why social dysfunction may be present across the range of injury severities. Overall, mTBI may specifically affect the social domain of adaptive functioning because social competence depends on child behavior and family environment which may both be perturbed after mTBI (Gagner et al, ; Ganesalingam et al, ), whereas practical and conceptual adaptive functioning include abilities less likely to be affected after mild brain injury such as motor function (Forsyth & Kirkham, ) and general intelligence (Anderson et al, ; Max et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…Overall, mTBI may specifically affect the social domain of adaptive functioning because social competence depends on child behavior and family environment which may both be perturbed after mTBI (Gagner et al, 2017;Ganesalingam et al, 2008), whereas practical and conceptual adaptive functioning include abilities less likely to be affected after mild brain injury such as motor function (Forsyth & Kirkham, 2012) and general intelligence (Anderson et al, 2001(Anderson et al, , 2004Max et al, 1998).…”

Section: Discussionmentioning

confidence: 99%

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Developmental trajectories of adaptive functioning following early mild traumatic brain injury

Dégeilh

Bernier

Gravel

et al. 2018

Developmental Psychobiology

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Adaptive behavior impairments have been reported in children with severe traumatic brain injury (TBI) but are not typically found following mild TBI. It is possible that mild TBI induces subtle changes in adaptive functioning that are not captured in conventional group comparisons. This study aimed to explore time course changes in adaptive functioning following early mild TBI. Parents of 63 children with mild TBI and 53 children with orthopedic injuries aged between 1.5 and 5 years at the time of injury completed the Adaptive Behavior Assessment System‐II at three time points: retrospectively to assess pre‐injury functioning, then at 6 and 18 months post‐injury. Developmental trajectories of adaptive functioning domains (practical, conceptual, and social) reported by parents were modeled using linear mixed‐model analyses. Findings suggest that mild TBI may disrupt the expected developmental progression of children's social adaptive behavior, but does not appear to alter practical and conceptual domains.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Developmental trajectories of adaptive functioning following early mild traumatic brain injury

Dégeilh

Bernier

Gravel

et al. 2018

Developmental Psychobiology

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“…In one series, 26% of previously healthy children surviving to discharge from paediatric intensive care had new physical impairments . The all‐cause incidence of physical impairment acquired postnatally is now comparable to that of cerebral palsy (CP) . An even larger group of children acquire purely cognitive morbidities, particularly after traumatic brain injury …”

Section: The Challenge Of Acquired Brain Injurymentioning

confidence: 99%

“…1 The all-cause incidence of physical impairment acquired postnatally is now comparable to that of cerebral palsy (CP). 2 An even larger group of children acquire purely cognitive morbidities, particularly after traumatic brain injury. 3 The variety of causes, severities, and distributions of acquired injuries hampers ABI research.…”

Section: The Challenge Of Acquired Brain Injurymentioning

confidence: 99%

The promotion of recovery through rehabilitation after acquired brain injury in children

Forsyth

Basu

2014

Develop Med Child Neuro

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A degree of motor recovery is typically seen after acquired brain injury in children. The extent to which rehabilitation efforts can claim credit for this is disputed. Strong correlations between late impairment outcomes and early severity and impairment indices are seen both in adults and children. These correlations have been interpreted by some as evidence that recovery is largely intrinsic and that any additional rehabilitation effects are small. Such views are belied by published animal studies demonstrating the possibility of large rehabilitation effects. Animal models suggest that to achieve similar rehabilitation treatment effect sizes in clinical practice, rehabilitation ‘doses’ should be greater, rehabilitation efforts should start sooner, and premature accommodation of impairment should be avoided.

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“…17,18 Slowed cognition, decreased attention, and memory impairment may make schoolwork a challenge upon return and require educational interventions. 12,15,19,20 Given the serious short-and long-term effects following mild traumatic brain injury, the application of appropriate initial management practices is essential. [21][22][23][24][25][26] Numerous guidelines for the management of concussion have been released from specialty groups (including sports medicine, neurology, pediatrics, and family medicine) and from large medical associations.…”

Section: Introductionmentioning

confidence: 99%

Canadian pediatric emergency physician knowledge of concussion diagnosis and initial management

Zemek

Eady

Farion

et al. 2015

CJEM

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Introduction: The diagnosis of concussion is a critical step in the appropriate management of patients following minor head trauma. The authors hypothesized that wide practice variation exists among pediatric emergency medicine physicians in the application of physical and cognitive rest recommendations following an acute concussion. Methods: The authors developed a 35-item questionnaire incorporating case vignettes to examine pediatric emergency physician knowledge of concussion diagnosis, understanding of initial management using return-to-play/school/work guidelines, use of existing concussion protocols, and perceived barriers to protocol use. Using a modified Dillman technique, the authors distributed an online survey to members of Pediatric Emergency Research Canada, a national association of pediatric emergency physicians. Results: Of 176 potential participants, 115 (65%) responded to the questionnaire, 89% (95% confidence interval [CI]: 0.81, 0.93) of whom reported having diagnosed 20 or more concussions annually. Although 90% (95% CI: 0.83, 0.94) of respondents adequately diagnosed concussion, only 64% (95% CI: 0.54, 0.72) correctly applied graduated return-to-play guidelines. Cognitive rest recommendations were also frequently limited: 40% (95% CI: 0.31, 0.49) did not recommend school absence, 30% (95% CI: 0.22, 0.39) did not recommend schoolwork reduction, and 35% (95% CI: 0.27, 0.45) did not recommend limiting screen time. Eighty percent (95% CI: 0.72, 0.87) of respondents reported having used guidelines frequently or always to guide clinical decisions regarding concussion. Conclusion: Despite a proficiency in the diagnosis of concussion, pediatric emergency physicians exhibit wide variation in recommending the graduated return to play and cognitive rest following concussion.

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Predicting outcome after childhood brain injury: Figure 1:

Cited by 44 publications

References 106 publications

Developmental trajectories of adaptive functioning following early mild traumatic brain injury

Developmental trajectories of adaptive functioning following early mild traumatic brain injury

The promotion of recovery through rehabilitation after acquired brain injury in children

Canadian pediatric emergency physician knowledge of concussion diagnosis and initial management

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