Preliminary validation study of the Sydney Post-Traumatic Amnesia Scale (SYPTAS) in children with traumatic brain injury aged 4 to 7 years

Cultural adaptation and validation of the Argentine Children's Orientation and Amnesia Test

The Children's Orientation and Amnesia Test (COAT) is a widely used tool for assessing post-traumatic amnesia (PTA) in children, yet no validated Spanish version exists. This study aimed to translate, culturally adapt, and linguistically validate the COAT into Argentine Spanish following the International Society of Pharmacoeconomic and Outcomes Research (ISPOR) guidelines. A Delphi panel of 10 experts evaluated item clarity, relevance, coherence, and comprehensiveness, while a pilot test with 14 healthy children (7 males, 7 females; mean age 7.9 years, SD 3.5) assessed comprehensibility and acceptance. The translation process revealed minor challenges in adapting culturally specific references, which were addressed through expert consensus. The pilot test confirmed that most items were well understood, though some children had minor difficulties with number sequences. No discomfort was reported during administration, supporting the tool's feasibility and acceptance. The Argentine version of the COAT represents a validated, culturally appropriate instrument for assessing PTA in children with traumatic brain injury. Its adaptation ensures conceptual equivalence while accounting for linguistic and cultural nuances. This study provides a crucial first step in making a standardized PTA assessment available for Spanish-speaking populations, facilitating its clinical use and future research. However, further psychometric validation in clinical populations is required to confirm its applicability in diverse healthcare settings.

Measuring behavioural disturbances exhibited by children and adolescents in post-traumatic amnesia: Development of a scale

Behavioural disturbances are often observed, but (to our knowledge) not systematically assessed, in children who are in post-traumatic amnesia (PTA) following traumatic brain injury (TBI). Therefore, we aimed to develop a prototype scale that measures the full range of behavioural disturbances exhibited by school-aged children in PTA. Quantitative and qualitative feedback was collected via online surveys. First, experts (n = 7) evaluated the relevance and developmental appropriateness of 37 behavioural items, extracted from the scoping literature review. Second, clinicians (n = 20) evaluated the preliminary scale for its suitability (acceptability, feasibility and usability). Analyses included descriptive statistics and qualitative analyses. First, experts eliminated nine items, adjusted the wording of three retained items and categorised 18 of the remaining 28 items into one of eight categories. Ten items were not consistently categorised. All experts highlighted that the scale needed to be short and easy to administer. Hence, categorised items were bundled, arriving at an 18-item preliminary scale. Second, clinicians deemed the preliminary scale highly suitable, easy to implement and addressing a gap in current clinical practice. The layout of the scale and wording of three items was modified according to qualitative feedback, arriving at an 18-item prototype. To our knowledge, this is the first scale designed to assess the full range of behavioural disturbances in children in PTA. The scale has the potential to systematically assess behaviour and streamline documentation of behavioural recovery in this population, inform management and rehabilitation, track responses to interventions and facilitate discussion with affected families.

Identifying Suitable Cognitive Assessments for Children and Adolescents with Acquired Brain Injury for use by Occupational Therapists in Acute and Subacute Hospital Contexts: A Scoping Review

AIM

To appraise the literature evaluating psychometric properties and clinical utility of cognitive assessments available for use by occupational therapists in acute and subacute hospital contexts with children aged 4-18 years diagnosed with an acquired brain injury.

METHODS

Scoping review. Assessments and associated studies were evaluated for their methodologic quality using the COnsensus-based standard for the Selection of health Measurement INstruments (COSMIN) strategy.

RESULTS

Forty-one studies evaluated 49 different assessments and reported on assessment psychometrics (n = 40), clinical utility (n = 1) and five reported on both. Fourteen assessments with the strongest psychometric properties and clinical utility were shortlisted.

CONCLUSION

A gold standard assessment was not identified. Instead, a shortlist of functional, performance-based, technology-based, and self-report assessments were identified as relevant for the setting and population, but requiring further investigation. Future development of a cognitive assessment in partnership with therapists working in tertiary pediatric settings will ensure optimal clinical utility and validity.

Post-concussive Signs and Symptoms in Preschool Children: A Systematic Review

Mild traumatic brain injury (mTBI) is common in children aged < 5 years, however, less is known about their experience of post-concussive signs and symptoms. This systematic review aims to identify post-concussive signs and symptoms experienced by preschool children up to 12 months post-injury, and to review the methods used to report this data. Relevant findings, including rates, progression, and possible predictors of post-concussive signs and symptoms were also identified. Databases (Ovid MEDLINE, EMBASE, PsycInfo, PubMed, Scopus) and reference lists were searched for relevant articles, which were screened based on specified criteria. Eleven articles met the inclusion criteria, being original studies published in English and presenting data on post-concussive signs and symptoms specific to preschool children with mTBI. Most reviewed studies investigated acute presentations of mTBI, and identified that preschool children demonstrate post-concussive symptoms (PCS) similar to other age groups. Post-traumatic amnesia duration of approximately one day was reported in preschool children following mTBI, as were changes in mood and behavior during the recovery period. Parents were the main informants, with data obtained through either interview or questionnaire. Review findings highlight the lack of empirical data regarding the presentation and progression of PCS in preschoolers following mTBI and evidence on how to best manage this group during recovery.