Relationship Between Self-Reported Symptoms and Neuropsychological Performance in School-Aged Children and Adolescents With Mild Traumatic Brain Injury

The Centers for Disease Control and Prevention recommends multimodal assessment to evaluate recovery from pediatric mild traumatic brain injury (mTBI) including symptom rating scales and neuropsychological testing. However, little is known about how strongly self-reported symptoms of mTBI are related to neuropsychological functioning, particularly in younger children. This study explored the relationship between self-reported symptoms and performance on neuropsychological measures in a sample of clinically referred school-aged children (n = 47) and adolescents (n = 104) within 4 weeks of sustaining an mTBI. All participants completed their age-respective Post-Concussion Symptom Inventory and a targeted neuropsychological battery as part of their clinical follow-up. Higher self-reported symptoms were moderately associated with reduced cognitive processing speed and poorer verbal recall memory in the adolescent group. Verbal recognition memory had the strongest relationship with symptom ratings across age groups, such that verbal recognition memory was moderately correlated with symptoms in school-aged children and strongly correlated with symptoms in adolescents. These findings suggest that the relationship between self-reported symptoms and performance on neuropsychological measures may vary based on the developmental level of the child. Furthermore, a higher symptom burden may contribute to cognitive inefficiencies that are exacerbated by sustained cognitive exertion (e.g., neuropsychological testing). Results from this study provide additional support for multimodal assessment following pediatric mTBI. With an increased understanding of child-reported symptoms and neuropsychological performance within the first few weeks following injury, neuropsychologists and psychologists could provide brief, targeted interventions to reduce the likelihood of persistent postconcussive symptoms and protracted recovery. What is the significance of this article for the general public?This study is one of the first to assess the association between self-reported symptoms and performance on neuropsychological testing within the first month after sustaining a mild traumatic brain injury (mTBI) in children and adolescents. Findings indicated that neuropsychological performance was associated with adolescent self-reported symptoms, but no significant relationships were identified for school-aged children. Results from this study provide additional support for multimodal asses