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Published on: September 19, 2019
Parent and child ratings of child behaviour following mild traumatic brain injury
Kelly M Jones1, Nicola J Starkey2, Alice Theadom1
1a National Institute for Stroke and Applied Neurosciences, Faculty of Health and Environmental Studies , Auckland University of Technology , Auckland , New Zealand.
Insights
Parent and child ratings of behavior after mild traumatic brain injury (mTBI) show poor agreement, but both perspectives indicate similar recovery patterns over 12 months. This highlights the need for both parent and self-reports in assessing child behavior post-mTBI.
Area of Science:
- Pediatric neurology
- Child psychology
- Behavioral science
Background:
- Mild traumatic brain injury (mTBI) in children is frequently linked to parent-reported behavioral issues.
- The degree of alignment between parent and child self-reports of behavior following mTBI is not well understood.
Purpose of the Study:
- To investigate discrepancies in child behavior and recovery trajectories over 12 months post-mTBI using both parent and child perspectives.
- To analyze differences in parent and child ratings of hyperactivity, anxiety, and depression.
Main Methods:
- The study included 99 children (aged 8-15) with mTBI and their parents.
- The Behavior Assessment Scale for Children, version 2, was used to assess hyperactivity, anxiety, and depression at multiple time points post-injury.
- Bland-Altman limits of agreement and mixed-effects models were employed to analyze rating differences and recovery patterns.
Main Results:
- Significant differences were observed between parent and child ratings of hyperactivity, anxiety, and depression at baseline, persisting throughout the 12-month follow-up.
- Parents generally reported higher levels of child hyperactivity, anxiety, and depression compared to children's self-reports.
- Both parents and children reported a decrease in hyperactivity and anxiety symptoms over the 12-month period.
Conclusions:
- There is a notable lack of agreement between parent and child ratings of child behavior following mTBI.
- Despite rating discrepancies, both groups generally concur on the patterns of behavioral recovery within the first year after mTBI.
- The findings underscore the importance of incorporating both parental and self-reported data for a comprehensive assessment of child behavior after mild traumatic brain injury.
Background:
Mild traumatic brain injury (mTBI) in children is most commonly associated with parent-reported child behaviour problems. The extent to which parent and child ratings align is unknown.
Objectives:
To examine differences in child behaviour and patterns of recovery over the first 12 months following mTBI based on parent and child self-report.
Methods:
Ninety-nine children (8-15 years) with mTBI and one of their parents completed the Behavioural Assessment Scale for Children - version 2 to assess child hyperactivity, anxiety and depression at baseline, 1, 6 and 12 months post-injury. Differences between ratings from parents and children were evaluated using Bland-Altman limits of agreement analyses. Child recovery over time was examined using mixed models repeated measures analyses.
Results:
Parent and child ratings for child hyperactivity, anxiety and depression differed significantly at baseline and these differences remained constant at each follow-up. Parents tended to report more child hyperactivity, anxiety and depression. Over time, parents and children reported fewer child hyperactivity and anxiety problems.
Conclusions:
Parents and children have poor agreement in ratings of child behaviour yet there is general agreement in patterns of recovery in the year following mTBI. Findings show the importance of considering both parent and self-report of child behaviour.
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