Does Mild Head Injury in Childhood Affect Later School Performance? A Sibling Comparison Cohort Study.

Abstract

To assess long-term effects of mild head injury (MHI) during childhood on school grades and high school eligibility. Children with MHI aged 6-16 years at the time of injury were followed up with register linkage and compared with their siblings in their total school grade score, grades in mathematics and Swedish language, as well as high school eligibility at the end of compulsory school. Patients were analyzed according to their recovery level at 3 months post-MHI using their Glasgow Outcome Scale Extended score. Educational outcomes were analyzed using generalized estimating equations with adjustment for relevant covariates using the genmod procedure in SAS. This study included 663 patients with MHI and 1003 siblings. The patients with MHI (34% female) had a mean age at injury of 12.2 years and a mean follow-up time of 3.8 years. This study was not able to detect any significant difference in school grades or high school eligibility for patients with MHI, with a good recovery level when compared with the siblings. However, patients with a poorer recovery level at 3 months after MHI showed a lower total grade score mean compared with the siblings. Children with no sequelae 3 months after MHI perform similarly to their siblings in later school performance. However, children with poorer short-term recovery levels show poorer long term school performance than their siblings.