DIVERGENT INTERPRETATION OF POST-CONCUSSIVE SYMPTOMS BETWEEN PARENT AND CHILD

Abstract

Background:Self-report symptom scales are often given to both parents and the injured child to rate a child’s symptoms following concussion. Previous research has shown that individual symptom reporting may not reflect agreement between parent and child. While total calculated scores may reflect agreement, looking at the total number of items reported may provide more insight into consistency between parent and child symptom rating following concussion.Purpose/Hypothesis:To evaluate the degree of divergence in post-concussive symptom reporting between parent and child. It was hypothesized the parent would endorse their child as having more symptoms following their concussion than self-reported by the child.Methods:The concussed child and their parent completed the Post-Concussion Symptom Inventory (PCSI), a self-reported concussion symptom scale to document symptoms related to the injury. The concussed child completed the age-appropriate version (8-12 years-old or 13-18 years-old) of the PCSI while the parent reported their perception of symptoms experienced by the child. The parent version of PCSI has 26 items, the adolescent version has 25 items, and the child version has 23 items. The total number of symptoms endorsed were calculated by recoding each symptom as a 0 or 1 variable to account for the item differences on the scales. A difference in total items reported, between parent and child as well as parent and adolescent PCSI, were calculated.Results:A total of 36 patients, 15 males and 21 females aged 8-18 (13.8±12.1 years), filled out the PCSI with 10 patients filling out the 8-12 years-old version and 26 filling out the 13-18 years-old version. The 10 parents of children ages 8-12, endorsed 2.9±2.7 more concussion symptoms. Of the 26 parents to adolescents ages 13-18, 1.08±6.28 more concussion symptoms were reported.Conclusion:Current results suggest the parents endorse their child experiencing more symptoms following their concussion than what is self-reported by the child. A future study to investigate the impact of parents’ elevated PCSI score(s) (i.e. total score or endorsed items) when compared to patient’s duration of recovery is recommended. This research would provide more comprehensive guidelines for recovery by means of patient and parent education.