From concussion to classroom: Predicting post-concussion pediatric school functioning

Abstract

Pediatric concussion is a common injury that can impact many children annually, and while most children return to school within 2 weeks post-concussion, many experience ongoing symptoms that can significantly impair school functioning. Moreover, children with preexisting learning conditions may be at even greater risk for delayed return-to-learn. However, there is limited research examining what factors predict school functioning 1 month post-concussion. Therefore, this study aimed to investigate whether initial post-concussion symptom severity predicted school functioning outcomes at 1 month post-concussion, while accounting for pre-existing learning conditions and demographics.

This research involved 275 children and adolescents aged 5-17 years old who had sustained a concussion. Parent reports were analysed which included the Post-Concussion Symptom Inventory and Pediatric Quality of Life Inventory, as well as study specific demographic questions. We used a hierarchical multiple linear regression to examine whether initial PCSI symptom severity predicted PedsQL school functioning outcomes at 1 month post-concussion, while accounting for pre-existing learning conditions and demographics.

The results showed that more severe initial PCSI symptoms significantly predicted worse school functioning outcomes at 1 month post-concussion (R2 = .12, F(6, 158) = 3.53, p = .003), supporting our main hypothesis. However, pre-existing learning conditions did not significantly predict school functioning outcomes, which failed to support our second hypothesis. The final model accounted for 11.8 percent of the variance in school functioning outcomes.

In conclusion, this research demonstrates that initial post-concussion symptom severity predicts school functioning outcomes at 1 month post-concussion, while pre-existing learning conditions did not. These findings highlight the importance of comprehensive symptom assessment and individualised support plans for children returning to school.