Behavioural problems and concussion in preschoolers

This study investigates the adverse consequences of concussions on young children.

This study investigates the adverse consequences of concussions on young children.

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Parents should look for behavioural changes in their children – and also in themselves.

Concussions are a major public-health problem due to their high prevalence in teens and athletes who take part in contact sports. The prevalence is even higher in preschool children because they have a more limited understanding of danger and are therefore more prone to injury. A study conducted by researchers at CHU Sainte-Justine, affiliated with Université de Montréal, and recently published in Psychological Medicine, reveals that even several months after suffering head trauma, children between the ages of 0 and 5 years old still exhibit behavioral problems.

“Even in its most benign form, a concussion that occurs early in a child's development can cause brain disorders that will persist even six months after sustaining the injury – the young brain is still immature and in full development, making it very vulnerable to shock,” said the study's principal author, Miriam Beauchamp, a CHU Sainte-Justine researcher and psychology professor at Université de Montréal. This research is in response to a previous study, published in the Journal of Neuropsychology, that revealed the side effects of concussions in youths on the quality of interpersonal relations with their parents.

To determine the adverse consequences of concussions on young children, Beauchamp's team evaluated the presence of behavioral problems in more than 200 children, six months after they had suffered a head trauma. “We asked the mothers to fill out a questionnaire to document a variety of problematic behaviors in their children, whether presented in an internalized way, such as anxiety or sadness, or in a more externalized way, such as anger or aggressiveness,” said the study's first author Charlotte Gagner, a doctoral student in neuropsychology at UdeM. The results show that mothers of children who have suffered a concussion report more behavioral problems, both internalized and externalized, than mothers whose children had not been injured or had sustained a non-head injury.

These results suggest that a head injury, even a “mild” one, can lead to brain injuries that make the child more susceptible to suffering from anxiety and anger, for example. “We also believe that mothers whose children have suffered a shock to the head worry more and therefore are more likely to detect certain subtle behavioral changes that would otherwise go unnoticed,” Gagner added. It is interesting to note that there is a strong correlation between children presenting more behavioral problems and parents who describe themselves as being more stressed. This highlights how important it is for parents to take care of their psychological health by reducing sources of stress and thereby maximize the positive aspects of their relationship with their child and lessen the consequences the concussion has had on their behaviour.

 “We now need to determine whether these behavioral problems will lessen over time or, on the contrary, whether they will become chronic or more severe," said Beauchamp. "To this end, we are continuing the study, re-evaluating these same children 18 to 30 months after the incident. Moreover, we are interested in learning whether, for the same types of behavioral problems, the father's perception of them will differ from the mother's."

About the study

Behavioral consequences of mild traumatic brain injury in preschoolers” was published online in the November 2017 edition of Psychological Medicine. The first author is Charlotte Gagner, a doctoral student in neuropsychology at Université de Montréal, under the direction of Miriam Beauchamp, the main author. Beauchamp is a researcher at the CHU Sainte-Justine, a neuropsychologist and assistant professor in the Department of Psychology of Université de Montréal; she is also director of the ABCs Development Neuropsychology Laboratory and adjunct professor in the Department of Neurology and Neurosurgery of McGill University. Beauchamp received financial assistance for her work from the Canadian Institutes of Health Research (CIHR) and a salary award from the Fonds de recherche du Québec – Santé (FRQS); her research facilities have the financial support of the Canada Foundation for Innovation (CFI).

About the CHU Sainte-Justine Research Centre

CHU Sainte-Justine Research Centre is a leading mother-child research institution affiliated with Université de Montréal. It brings together more than 200 research investigators, including over 90 clinicians, as well as 350 graduate and post-graduate students focused on finding innovative means of prevention, faster and less invasive treatments, and personalized approaches to medicine. The Centre is part of CHU Sainte-Justine, which is the largest mother-child hospital in Canada and second most important pediatric hospital in North America.

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