The impact of concussion on school performance in Australian children: a population-based matched cohort study

R. Lystad, A. McMaugh, G. Herkes, G. Browne, T. Badgery-Parker, C. Cameron, R. Mitchell

Research output: Contribution to journalMeeting abstractpeer-review

Abstract

Introduction: School children who sustain a concussion may experience cognitive and behavioural changes that may impact on their ability to learn, which may lead to poorer educational outcomes. This study aimed to compare academic performance and high school completion of young people hospitalised with concussion and matched peers not hospitalised with concussion.
Methods: A population-based, matched case-comparison cohort study of young people aged ≤18 years hospitalised with concussion during 2005-2018 in New South Wales, Australia, using linked birth, health, education, and mortality records. The comparison cohort was matched on age, sex, and residential postcode. Multi-level generalised linear mixed modelling was used to examine risk of not achieving the national minimum standard (NMS) on standardised tests for numeracy and reading in school grades 3, 5, 7, and 9, and generalised linear regression was used to examine risk of not completing high school years 10, 11, and 12, for young people hospitalised with concussion compared to matched peers not hospitalised with concussion during the study period. The final models accounted for available covariates (i.e. sex, socioeconomic status, non-English language background status, comorbidity status, and parental education) to derive adjusted relative risks (ARR) with 95% confidence intervals (CI).
Results: The number of young people hospitalised with concussion where a matched peer could be identified was n=1,049 for school grade 3; n=1,035 for school grade 5; n=932 for school grade 7; n=689 for school grade 9; n=1,445 for high school year 10; n=1,366 for high school year 11; and n=1,182 for high school year 12. Young people hospitalised with concussion had 30% higher risk of not achieving the NMS for numeracy (ARR 1.30; 95%CI 1.05–1.62; p=0.0165) and 40% higher risk of not achieving the NMS for reading (ARR 1.40; 95%CI 1.17–1.67; p=0.0002) in school grades 3-9, compared to matched peers. Young people hospitalised with concussion had a 64% higher risk of not completing high school year 11 (ARR 1.64; 95%CI 1.38–1.94; p<0.0001) and 75% higher risk of not completing high school year 12 (ARR 1.75; 95%CI 1.48–2.06; p<0.0001), compared to matched peers.
Discussion: Young people hospitalised with concussion have higher risk of not achieving minimum standards for numeracy and reading and not completing high school compared to matched peers not hospitalised with concussion. There is a need to improve return to learning and recovery management for young people with concussion to mitigate adverse effects of concussion on education, including potential sequelae such as early school leaving and unemployment and poverty in adulthood.
Impact/Application to the field: This is the world’s first population-based study to estimate the impact of concussion on school children’s performance on national standardised tests for numeracy and reading and high school completion.
Original languageEnglish
Article numberO100034
Pages (from-to)S36-S37
Number of pages2
JournalJournal of Science and Medicine in Sport
Volume25
Issue numberSupplement 2
DOIs
Publication statusPublished - Nov 2022
Event2022 Sports Medicine Australia Conference - Gold Coast, Australia
Duration: 16 Nov 202219 Nov 2022

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