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Does Concussion Impact a Child’s IQ?

August 18, 2023

Written by Aaron Lacy

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At least in the initial period, there appears to be no clinically meaningful difference in IQ scores in pediatric patients after a concussion. 

Scores dropping after getting your bell rung?
Mild traumatic brain injuries (i.e. concussions), affect millions of children in North America each year. Both parents of and children who suffer a concussion will have many questions and concerns about what to expect going forward. This study drew from two prospective cohorts of children who had suffered concussion or orthopedic injury (n=866). Those with concussions were compared to those with mild orthopedic injuries. The authors used linear, Bayesian, and invariance models to look for relation between concussion symptoms and IQ scores 1-month post injury.

Fortunately for patients, when comparing full scale IQ (0.13; 95%CI 0.00-0.26) and matrix reasoning (0.16; 95%CI 0.03-0.30), there were only small differences between groups, both which were not felt to be clinically significant. There was no difference noted in vocabulary scores (0.005; 95%CI -0.08-0.19).

Given that the authors had to pull from already existing injury cohorts (MIOS and A-CAP) and used three separate analytical models, this paper has an intimidating amount of hardcore statistical content and discussion. For the average clinician it may read as a bit of alphabet soup, but the key takeaway is that the authors were robust in their reasoning and application of these statistics.

How will this change my practice?
Parents of, and patients who have suffered mild traumatic brain injury are often incredibly worried about what to expect. I spend much more time discussing post-concussive care (let thy child sleep) and expectations than I do diagnosing the concussion. I already discuss timeline of return to the field, the classroom, light exercise, and the role of screen time with families – but often the biggest role I play is providing reassurance. While this study doesn’t allow us to comment on the long-term outcomes of mild TBI in children, I can at least let parents and patients know that in the short term they won’t see a decline in intelligence.

IQ After Pediatric Concussion. Pediatrics. 2023. 152(2);e2022060515. https://doi.org/10.1542/peds.2022-060515.

What are your thoughts?