Impact of early intervention on outcome after mild traumatic brain injury in children

Objectives. The impact of mild head injury or mild traumatic brain injury ( TBI) in children is variable, and determinants of outcome remain poorly und erstood. There have been no previous attempts to evaluate the impact of int erventions to improve outcome. Results of previous intervention studies in adults have been mixed. This study aimed to evaluate the impact of providin g information on outcome measured in terms of reported symptoms, cognitive performance, and psychological adjustment in children 3 months after injury . Methods. A total of 61 children with mild TBI were assessed 1 week and 3 mo nths after injury, and 58 children with mild TBI were assessed 3 months aft er injury only. They were compared with 2 control groups (N = 45 and 47) of children with minor injuries not involving the head. Participants complete d measures of preinjury behavior and psychological adjustment, postconcussi on symptoms, and tests of attention, speed of information processing, and m emory. Children with mild TBI seen at 1 week were also given an information booklet outlining symptoms associated with mild TBI and suggested coping s trategies. Those seen 3 months after injury only did not receive this bookl et. Results. Children with mild TBI reported more symptoms than controls at 1 w eek but demonstrated no impairment on neuropsychological measures. Initial symptoms had resolved for most children by 3 months after injury, but a sma ll group of children who had previous head injury or a history of learning or behavioral difficulties reported ongoing problems. The group not seen at 1 week and not given the information booklet reported more symptoms overal l and was more stressed 3 months after injury. Conclusions. Providing an information booklet reduces anxiety and thereby l owers the incidence of ongoing problems.