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Cognitive and Behavioral Outcome Following Mild Traumatic Head Injury in Children

Ponsford, Jennie PhD; Willmott, Catherine MSc; Rothwell, Andrew MSc; Cameron, Peter FACEM; Ayton, Gary MBBS; Nelms, Robyn Grad Dip App Psych; Curran, Carolyn MPsych; Ng, Kim T PhD

Journal of Head Trauma Rehabilitation: August 1999 - Volume 14 - Issue 4 - p 360–372
Neurobehavioral Issues in Pediatric Head Trauma

Objectives: To investigate outcome in children with mild traumatic head injury (THI) at 1 week and 3 months postinjury and to identify factors associated with persisting problems.

Design: Postconcussional symptomatology, behavior ratings, and neuropsychological test performance were examined at 1 week and 3 months postinjury.

Setting: Participants were recruited from successive presentations to emergency departments of two major hospitals.

Participants: 130 Children with mild THI were compared with 96 children having other minor injuries as controls.

Results: Children with mild THI experienced headaches, dizziness, and fatigue but exhibited no cognitive impairments, relative to controls, at 1 week postinjury. By 3 months, symptoms had resolved. However, 17% of children showed significant ongoing problems. They were more likely to have a history of previous head injury, learning difficulties, neurological or psychiatric problems, or family stressors.

Conclusions: Persisting problems following mild head injury in children are more common in those with previous head injury, preexisting learning difficulties, or neurological, psychiatric, or family problems. These “at-risk” children should be identified in the emergency department and monitored.

Manager, Psychology and Research, Bethesda Hospital, Monash University* (Ponsford)

Neuropsychologist, Bethesda Hospital† (Willmott)

Neuropsychologist, Howe Rehabilitation Services, Julia Farr Services South Australia* (Rothwell)

Associate Professor, Emergency Medicine, Royal Melbourne Hospital* (Cameron)

Assistant Director, Emergency Department, Western Hospital† (Ayton)

Research Assistant, Psychology and Research, Bethesda Hospital† (Nelms)

Neuropsychologist, Bethesda Hospital† (Curran)

Professor and Head of Department, Monash University* (Ng)

This research was funded by a grant from the Ministerial Implementation Committee on Head Injury, Health Department of Victoria.

Address for correspondence and reprints: Dr. Jennie Ponsford, Department of Psychology, Bethesda Hospital, 30 Erin Street, Richmond, Victoria, 3121, Australia (electronic mail:

© 1999 Lippincott Williams & Wilkins, Inc.