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Abstract
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In this issue of Pediatrics, Ware et al1 find that intellectual functioning is not affected as early as 3 to 18 days postconcussion and up to 3 months later. Their methodologically rigorous approach from 2 large samples accounted for factors such as socioeconomic status and has an orthopedic injury control group.
Variability in the concussion outcomes literature has in large part been due to inconsistency in study methods and rigor, including heterogeneity of the clinical sample, inclusion and choice of control groups, and variability in how the outcome of interest is defined and measured. There is considerable difference in traumatic brain injury outcomes on the basis of the nature and severity of the injury. Also important is not only whether there is a control group but its comparability. For example, it is insufficient to use an age- and sex-matched healthy cohort alone. Other considerations should include factors associated with outcome of interest, in this case intellectual ability, such as parent education, parenting practices, and environmental influences that enrich or disadvantage cognitive development.2 It is equally important to distinguish between a healthy cohort and one that has undergone an orthopedic injury, the latter of which can more accurately account for the disruptions to a young nervous system that has experienced an injury to a body part other than the brain, or personal or environmental factors that may predispose one to an injury...
Language: en |