Sensory processing patterns in pediatric mild traumatic brain injury: a longitudinal study

Background: Difficulties with SP, such as sensitivity to sensory input, have been associated with an increased recovery time and persistence of other post-concussive symptoms after mTBI in adults. An extensive evaluation of SP over various sensory inputs after pediatric mTBI, and over time, is currently lacking. With the present longitudinal study, we examined SP patterns of children and adolescents aged 6-17 years who sustained an mTBI. Methods: 241 children participated at 2 weeks and 6 months post-injury. For children aged 6-11 years (n=120), caregivers completed the SSP-NL. Adolescents aged 12-17 years (n=121) completed the self-report version of the AASP-NL. Scores on these measures were compared to norm data. To identify classes (i.e., patterns within the data), an MLCGA was performed. To investigate the implications of these patterns, we linked them to daily activities and participation as measured with the CASP. Results: Within the child-mTBI group, four classes of SP were identified: 1) taste and smell sensitive, 2) general hypersensitivity, 3) general hyposensitivity, 4) underresponsive and auditory filtering problems, with class 2 having lower CASP levels than the other classes. Changes over time were limited, resulting in remaining SP problems (hyper- and hypo-sensitivities) at six months post-injury. For adolescents, two classes were identified: 1) avoidant & passive, and 2) mild, with class 1 having lower CASP levels than class 2. Additionally, class 2 showed decreases in Poor Registration, Sensory Sensitivity and Sensation Avoidance over time. No associations between classes and demographic- or injury-related characteristics could be identified.Conclusions: These results indicate inter-individual differences in SP after mTBI in children and adolescents and that subgroups are differentially associated with activities and participation. Early recognition of sensory processing symptoms could therefore be helpful to target interventions more effectively. Keywords: pediatric mTBI, sensory processing, class analysis, children, adolescents, participationAbbreviations: SP = sensory processing, mTBI = mild traumatic brain injury, SSP-NL = Dutch Short Sensory Profile, AASP-NL = Dutch Adolescent and Adult Sensory Profile. MLCGA = multivariate latent class growth analysis. CASP = Child and Adolescent Scale of Participation.