The Role of Pediatric Psychology in Concussion Care

Abstract

Objective

This study aimed to describe the process of establishing pediatric psychology services within a multidisciplinary concussion program as well as present data about patient service utilization and observed behavioral health needs among patients receiving care.

Methods

Data were gathered from a prospectively collected registry cohort of patients ages 3–23 presenting for pediatric psychology care following concussion at a large, urban children’s hospital in the Northeast United States. Patient- and caregiver-report of physical and psychosocial functioning were collected via standardized screening questionnaires.

Results

A total of 136 patients, or 7.3% of all patients receiving care in the broader concussion program, met with pediatric psychology. Patients were seen a median of 80.5 days from injury (range 7–1104) with 11% first seen within 30 days of injury. Once referred to psychology, 53.6% attended initial consultation. Psychosocial and physical functional impairment were common among patients seen by pediatric psychology. A majority (66.2%) of patients were referred for follow-up with pediatric psychology with a median of 4 follow-up sessions (range 1–30).

Conclusion

This study provides one example of pediatric psychology services offered to patients following concussion and highlights possible opportunities to expand care within this medical subspecialty including using behavioral health screening to inform pediatric psychology referrals, offering pediatric psychology support during the acute post-injury phase, and trialing integrated care models to improve rates of referral acceptance.

Implications for Impact Statement

Psychosocial needs (e.g., worry, sadness, or difficulty sleeping) are common after pediatric concussion and can impact recovery. Pediatric psychology services are uniquely suited to assess and support these needs and should be readily available to patients with identified risk factors at all phases of injury recovery.