Post-Concussive Symptoms and Their Association with Follow-Up Care in a Sample of Young Children with TBI.

BACKGROUND: Pediatric traumatic brain injury (TBI) is the leading cause of acquired disability in childhood and is associated with post-concussive symptoms (PCS) that may negatively impact recovery and long-term outcomes. Despite the importance of follow-up care after TBI, families from marginalized racial and ethnic backgrounds are less likely to receive follow-up care and rehabilitation. This study examined the association between PCS and follow-up care, as well as the types of follow-up care received, among young, racially and ethnically diverse children with TBI. METHODS: Data were collected from 36 families of children ages 2-5 years with a confirmed TBI in the past 3-6 months who completed screening procedures as part of a larger study. Parents reported demographic and injury characteristics, PCS, and whether they sought follow-up care after their child's emergency department visit. Regression analyses examined associations between PCS and follow-up care. RESULTS: Participants were 55.6% female, with a mean age of 3.60 years (SD = 1.22). Most children sustained mild injuries due to falls (77.8%). Headaches, drowsiness, balance difficulties, feeling slowed down, and behavior changes were individually associated with seeking follow-up care. In a regression model including all significant main effects, balance difficulties (B = 0.46) and drowsiness (B = 0.42) remained significant [F(5,30) = 6.11, p < 0.001]. Only 44.4% of parents sought follow-up care, and 33.3% of them followed up with a TBI specialist. CONCLUSIONS: Findings highlight low rates of post-injury follow-up and specialty care among young children with TBI, underscoring the need for improved caregiver education and first-line provider training.