Reliability of the Abbreviated Westmead Post-traumatic Amnesia Scale in children: Impact of age on test results

• Published in: Emergency medicine Australasia 2016-02, Vol.28 (1), p.73-77
• Main Authors: Tesson, Stephanie A, Nogajski, Rebecca R, Macey, Julie-Anne, Paget, Simon P
• Format: Article
• Language: English
• Subjects: Abbreviated Westmead Post-traumatic Amnesia Scale; Age Factors; Amnesia - diagnosis; Amnesia - etiology; Brain Concussion - complications; Brain Concussion - diagnosis; Brain Concussion - psychology; Child; Child, Preschool; concussion; Female; Humans; Male; mild traumatic brain injury; Neuropsychological Tests; paediatric; post-traumatic amnesia; Reproducibility of Results
• ISSN: 1742-6731; 1742-6723
• DOI: 10.1111/1742-6723.12502

Objective This study aimed to determine the reliability of the Abbreviated Westmead Post‐traumatic Amnesia Scale (A‐WPTAS) in children by examining the impact of age on A‐WPTAS performance. Methods Participants were typically developing patients with minor illnesses or injuries and/or accompanying siblings aged 5–10 years, attending a children's hospital ED. Exclusion criteria included: (i) a recent traumatic brain injury; (ii) developmental disability; (iii) recent drug administration judged to impact cognition; and/or (iv) non‐English speaking background. The A‐WPTAS was administered on two occasions separated by approximately 60 min. Logistic regression was used to determine the odds of passing based on age. Results A total of 125 children completed the A‐WPTAS assessments. A‐WPTAS pass rates were 36% for 5 year olds, 68% for 6 year olds, and exceeded 90% for 7–10 year olds. Compared with 9 year olds, 5 year olds had significantly lower odds of passing (P = 0.003), a trend that persisted for 6 year olds (P = 0.052). Among 5 and 6 year olds, failure was predominantly due to difficulty with temporo‐spatial orientation items. Conclusions The A‐WPTAS is reliable for use in children aged 7 years and older, while its use in children aged 6 years and under results in an unsatisfactory high false positive rate, limiting its clinical utility. The adult‐level performance of children aged 7 years onwards provides strong support for using the tool in the early management of these children with mild traumatic brain injury in Australian EDs.