A new means of determining concussion in young children has been developed, in an innovation which could help change the way they are treated and accurately diagnosed at the earliest stages.
Through the work of scientists at Université de Montréal, children up to five years of age can be assessed more accurately, with difficulties often arising in toddlers and pre-school children being able to describe their symptoms.
To address the lack of assessment tools for this age group, UdeM neuropsychology professor Miriam Beauchamp, who conducts research at the UdeM-affiliated CHU Sainte-Justine children’s hospital, designed a new observational tool that allows parents and clinicians to assess the child’s health status.
It is also designed to document the progression of symptoms and their severity over time, and also emphasises the importance of parents tracking changes in their child after a head injury.
Traditionally, it was suggested that TBI in early childhood may not have significant adverse effects, because the high plasticity of the brain at this time of life allowed for rapid recovery.
“This is true to some extent, but the reverse is also true,” said Prof Beauchamp, the study’s principal author.
“In young children, many things are not yet permanently consolidated. So when a shock disrupts brain function, the response can be as damaging as in older children.
“We felt it was paramount to develop a tool to document the physical, cognitive, and behavioural status of these children and allow for appropriate clinical management.”
In designing their new tool, the researchers listed all the known symptoms observed in older patients – headaches, memory loss, difficulty concentrating, hypersensitivity to light and noise, irritability, balance or coordination problems, dizziness, and sleep problems are among them.
They then catalogued, with the support of parents of children and the emergency care staff at CHU Sainte-Justine, post-concussion manifestations observed in very young children.
The research team then broke down these symptoms into observations that reflect their child’s actual condition.
“Unlike the questionnaires we use with older children, here we include examples to explain how symptoms can manifest in a young child,” says Prof Beauchamp.
“We also added observations that are potentially unique to this age group and therefore not found in existing questionnaires.
“For example, we asked questions about so-called comfort-seeking: ‘Is my baby in my arms more often?’ and ‘Does my child keep asking for their pacifier or stuffed animal?’
“We also use ‘regression’ observations: ‘Was my child potty trained, but is no longer?’ and ‘Did my child sleep through the night, but now wakes up at all hours?’”
The study has been hailed as being “very promising” in enabling future changes in how head injury in very young children is dealt with.
“This study is very promising, as it allows us to design patterns to validate our tool,” adds Prof Beauchamp.
“We are continuing our research to compare post-concussion symptoms with the behaviour of children who have not been injured in a large multi-centre study in Canada. Ultimately, we’ll be able to transfer the tool to clinical use throughout Quebec, and even internationally.”
