1554 - Associations between post-concussive symptoms and school needs following mild traumatic brain injury

Objectives: To explore the relationship between type and severity of symptoms following a mild traumatic brain injury (mTBI) and severity of subsequent school needs.

Design: A cross-sectional retrospective chart review of treatment-seeking youth with mTBI was conducted for youth who sustained a mTBI within six months of an initial multidisciplinary head injury clinic visit that occurred between September 1, 2021 and December 31, 2021. Parents and children completed the Post-Concussion Symptom Inventory (PCSI) quantifying their symptoms after brain injury. School specialists conducted the Brief School Needs Inventory (BSNI) to stratify academic risk. Additional considerations included demographic factors, mechanism of injury, school concerns, school accommodation changes, and prior TBI history. Descriptive statistics characterized clinical history, demographic information, BSNI, and PCSI data. Multiple linear regression was performed to test associations between BSNI scores and PCSI total symptom scores, controlling for age and time since injury.

Results: Seventy-four pediatric patients (n=41 female) met selection criteria and were included in the study. The most common symptom reported on the PCSI was headache (n=61, 82%), followed by dizziness or balance issues (n=36, 49%). At the time of appointment, most patients expressed concern about school (n=43) and had yet to return to their pre-injury level of school performance (n=58). On the BSNI, most patients reported concerns related to school attendance (n=41, 55%) and many reported concerns related to academic performance (n=25, 34%). Controlling for age and time since injury, total school risk as assessed by the BSNI was associated with the total parent reported PCSI score (β = 0.066, p < 0.001).

Conclusions: School needs are a significant issue for many youth recovering from mTBIs, and the number and severity of symptoms during an initial outpatient visit can be useful in terms of anticipating the needs and potential difficulties of patients returning to school post-injury.