title: Brief cognitive behavioral intervention for children and adolescents with persistent post-concussive symptoms: A pilot study.
abstract: This study aims to evaluate the efficacy of a brief cognitive behavioral intervention program for children and adolescents experiencing persistent post-concussion symptoms. A total of 31 patients aged 10 to 18 years participated in the intervention. The median time since injury at treatment onset was 95 days though the range was large (23-720 days). Treatment was on average four sessions in duration. Sessions included concussion education, activity scheduling, sleep hygiene relaxation training, and cognitive restructuring. Outcomes were measured using symptom reports on the Sports Concussion Assessment Tool - Third Edition (SCAT-3) and parent-reported quality of life on the Pediatric Quality of Life Inventory (PedsQL). Mixed-effects models revealed that symptom reports did not decrease prior to the initiation of this treatment, though significant symptom improvement occurred following treatment. Quality of life scores significantly improved across domains, with the largest gains made in the emotional and school domains. Participant characteristics including age, sex, maternal education, and previous mental health problems were not found to be significantly related to treatment outcomes. Contrary to predictions, length of time since injury was not related to symptom changes. The primary limitation of this study is that it lacks randomization and an experimental control group. The results suggest that brief cognitive behavioral intervention may be a promising treatment for children and adolescents experiencing persistent post-concussive symptoms and warrants further investigation.
authors.affiliation: a Section of Pediatric Psychology and Neuropsychology , Nationwide Children's Hospital , Columbus , OH , USA.|b Department of Pediatrics , The Ohio State University , Columbus , OH , USA.
authors.forename: Kelly A
authors.initials: KA
authors.lastname: McNally
authors.affiliation: a Section of Pediatric Psychology and Neuropsychology , Nationwide Children's Hospital , Columbus , OH , USA.
authors.forename: Kristina E
authors.initials: KE
authors.lastname: Patrick
authors.affiliation: c The Research Institute , Nationwide Children's Hospital , Columbus , OH , USA.
authors.forename: Jacob E
authors.initials: JE
authors.lastname: LaFleur
authors.affiliation: a Section of Pediatric Psychology and Neuropsychology , Nationwide Children's Hospital , Columbus , OH , USA.
authors.forename: Jana B
authors.initials: JB
authors.lastname: Dykstra
authors.affiliation: a Section of Pediatric Psychology and Neuropsychology , Nationwide Children's Hospital , Columbus , OH , USA.
authors.forename: Kerry
authors.initials: K
authors.lastname: Monahan
authors.affiliation: b Department of Pediatrics , The Ohio State University , Columbus , OH , USA.|c The Research Institute , Nationwide Children's Hospital , Columbus , OH , USA.
authors.forename: Kristen R
authors.initials: KR
authors.lastname: Hoskinson
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000534:rehabilitation*; D001924:Brain Concussion / Q000209:etiology / Q000534:rehabilitation*; D002648:Child; D003071:Cognition; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D038223:Post-Concussion Syndrome / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D011788:Quality of Life / Q000523:psychology*; D016896:Treatment Outcome; D000067009:Youth Sports / Q000293:injuries*
keywords: Concussion; Pediatric; Post-concussion syndrome; Rehabilitation; Traumatic brain injury