Research Reports - Brief cognitive behavioral intervention for children and adolescents with persistent post-concussive symptoms

Child Neuropsychol. 2017 Jan 26:1-17. doi: 10.1080/09297049.2017.1280143. [Epub
ahead of print]

McNally KA(1,)(2), Patrick KE(1), LaFleur JE(3), Dykstra JB(1), Monahan K(1),
Hoskinson KR(2,)(3).

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

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