Post-Traumatic Amnesia in Children



Suncica Lah


Suncica Lah
Naomi Brookes
Linda Ewing-Cobbs
Louise Parry
Adrienne Epps



The aims of this preconference is to examine clinical practices and research into post-traumatic amnesia (PTA) in children and develop future strategies for clinical and scientific collaboration. The specific objectives of the preconference are to: (i) bring scientists and practitioners together to share their experiences in PTA assessments in children across the TBI severity continuum, (ii) examine how PTA assessments are used for inpatient management and prediction of outcomes, (iii) identify barriers in using PTA assessments in children with TBI, (iv) develop recommendations for future clinical and scientific collaboration on child PTA.

Post-traumatic amnesia (PTA) is a period following traumatic brain injury (TBI) during which a person is confused, disoriented, unable to form day to day memories, and presents with behavioural disturbances. PTA duration is one of the clinical indicators of TBI severity, and a predictor of long-term functional recovery. Assessment of PTA involves daily administration of a standardised scale, which measures (i) orientation (to person, place and time) and (ii) continuous (episodic) memory for new events. PTA assessments provide unique information about early cognitive recovery and are important for discharge planning and prediction of outcomes. While children are particularly susceptible to TBI, a major gap exists in utilisation of PTA assessments in clinical work and in research into child PTA.

In this preconference we will present research and clinical experiences in assessing PTA in children during acute stages of recovery from TBI. We will focus on two scales that are in frequent clinical use internationally: Children's Orientation and Amnesia Test (COAT), and Westmead Post Traumatic Amnesia Scale (WPTAS). The emphasis will be on the use of these scales to predict outcomes. We will present research that provides findings on the group level. We will discuss how to use these findings in prognosis of individual outcomes. We will provide clinical cases to illustrate predictions of outcomes in individual patients. In addition, we will examine two factors that may compromise children’s responses on PTA assessments, and lead to erroneous conclusions that children are in PTA when they are not. The two factors are: opiate analgesic medication and young age at injury. We will present findings of our recent study that examined the impact of opiate analgesic medication administered to children who underwent surgeries (but have not sustained head injuries) on the WPTAS scores. Finally, we will present findings of studies that examined whether orientation and memory items that are typically included in PTA scales for adults and school aged children are suitable for children aged 4 to 7 years. These studies led to development of a new scale for assessment of PTA in this young age group: Sydney Post-Traumatic Amnesia Scale (SYPTAS).



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