Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Pediatric Concussion

Managing Persistent Symptoms With an Interdisciplinary Approach

Scratch, Shannon E. PhD; Rumney, Peter MD; Agnihotri, Sabrina MD, PhD; Reed, Nick PhD

Section Editor(s): Bazarian, Jeffrey J. MD, MPH

The Journal of Head Trauma Rehabilitation: November/December 2019 - Volume 34 - Issue 6 - p 385–393
doi: 10.1097/HTR.0000000000000542
Original Articles
Buy

Objective: We outline the development of a clinic that works directly with youth clients, their caregivers, and family members to help address symptoms that are persisting long after the youth sustained a concussion. Client referral characteristics are described, as well as general clinic flow and procedures. Particular emphasis is placed on a novel interdisciplinary team assessment pathway designed with input from clients and families to help provide consistent treatment plans, education, direction, and conclusions for those clients with complex psychosocial, cognitive, and physical presentations.

Setting and Participants: The Persistent Concussion Clinic at Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.

Conclusions: Youth with persistent concussion symptoms have limited access to interdisciplinary clinics and supports. This article outlines the practices of a large, hospital-based interdisciplinary clinic whose model can inform clinical care pathways and practices for this underserved population. Facilitators and barriers to access are discussed and future directions for the clinic and persistent concussion care in Ontario and internationally are reviewed.

Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada (Drs Scratch, Rumney, Agnihotri, and Reed); and Department of Paediatrics (Dr Scratch), Rehabilitation Sciences Institute (Drs Scratch and Reed); Department of Psychiatry (Dr Agnihotri), and Occupational Science and Occupational Therapy (Dr Reed), University of Toronto, Canada.

Corresponding Author: Shannon E. Scratch, PhD, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, ON M4G 1R8, Canada (sscratch@hollandbloorview.ca).

Dr Scratch conceptualized and designed the initial design, drafted initial manuscript, and approved the final manuscript as submitted. Dr Rumney contributed to manuscript writing, reviewed and revised the manuscript, and approved the final manuscript as submitted. Dr Agnihotri contributed to manuscript writing and data pull and approved the final manuscript as submitted. Dr Reed conceptualized and designed the initial design, drafted manuscript, and approved the final manuscript as submitted.

We would like to thank the exceptional clinicians and management team involved with the Persistent Concussion Clinic at Holland Bloorview Kids Rehabilitation Hospital, including Cyndy Bryson, Dr Alysha Ladha, Dr Ryan Hung, Dr Janine Hay, Dr Lily Riggs, Naomi Smith, Debra Moroz, Kim Moody, Andrea Hickling, Erin Kohlmetz, Charlotte Coy, Nick Joachimides, and Elaine Widgett. We would also like to acknowledge the youth, caregivers, and families who access our clinic, as well as those who participate in ongoing clinical research projects to support improvement and development of rehabilitation services for youth with persisting symptoms post-concussion.

The authors declare no conflicts of interest.

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.