An Examination of Concussion Symptom Base Rates for Children Aged 5–18 Years

Abstract

The aim of this research was to establish base rate levels of frequency and severity of concussion symptoms for normally developing New Zealand children aged 5 to 18 years. A further aim was to compare the rates obtained through parental report with a previous study based on the self-report of New Zealand children aged 11–13 years and with studies conducted in the USA also based on parental report. Parents completed an online survey composed of items from the Post-Concussion Symptom Inventory–parental form (PCSI-p) with additional items from Couch and Leathem (2011). Symptoms of “irritability,” “frustration,” and “impatience” were commonly reported on a daily or weekly basis, and these symptoms plus “sadness,” “emotionality,” “fatigue,” and “disorganisation” were reported at least monthly. The mean severity rating of symptoms was low, with a weak correlation between severity and frequency. Examination of differences in PCSI-p total scores revealed no difference across age bands. Self-report of symptom frequency was significantly higher in the Couch and Leathem study than parental report in the same age group in the current study which were in turn higher than reported by Sady et al. (Archives of Clinical Neuropsychology, 29, 348-363, 2014) and Gioia et al. (Journal of the International Neuropsychological Society, 14(S1), 204, 2008). There were no significant differences found between males and females for total score, although females scored significantly higher than males for “emotionality.” Some symptoms of concussion are reported in normally developing children in the absence of concussion. Differences in methodology affect reported base rates, and hence, when referring to base rates in a clinical setting, attention should be paid to the methodology used.