Discrepancies in child and parent reporting of concussion symptoms

Area of Science:

• Pediatric neurology
• Sports medicine
• Clinical psychology

Background:

• Concussion assessment in children and adolescents often relies on self-report symptom inventories.
• Discrepancies between child and parent symptom reporting can impact diagnosis and management.
• Understanding these discrepancies is crucial for accurate concussion evaluation in young populations.

Purpose of the Study:

• To evaluate the extent of agreement between child and parent symptom reports following concussion.
• To identify specific symptoms or domains where discrepancies are most pronounced.
• To determine the influence of time post-injury on symptom reporting agreement.

Main Methods:

• A prospective cohort study included 61 patients aged 7-21 years diagnosed with concussion.
• Child and parent symptom inventories (Child SCAT-3) were administered at enrollment and 4 weeks post-injury.
• Statistical analyses included t-tests, Pearson correlations, and repeated measures ANOVA to compare reports and assess agreement over time.

Main Results:

• Children reported higher symptom severity for 'distracted easily' and 'confused' at enrollment.
• Moderate-to-high agreement between child and parent reports was observed for 18/20 symptoms at enrollment, decreasing to 14/20 at 4 weeks.
• Age did not significantly affect the discrepancy between child and parent symptom reports.

Conclusions:

• While overall agreement between child and parent concussion symptom reports is moderate-to-strong, notable discrepancies exist, particularly for cognitive symptoms.
• Adolescents may under-report or under-recognize cognitive deficits following concussion.
• Incorporating parent-reported symptom scales is recommended for comprehensive tracking of cognitive symptoms in pediatric concussion patients.