B-29: A Pilot Investigation Into Child and Parent Concordance in Emotional and Behavioral Symptomatology Following Pediatric Neurocritical Care

Abstract

Objective: Advances in PICU survival have shifted focus from mortality to long-term outcomes. Post-intensive care syndrome in pediatrics (PICS-p) encompasses dysfunction across cognitive, emotional/behavioral, physical, and social health domains. While physical and cognitive outcomes are emerging as well-studied, emotional and behavioral functioning remains underexplored. Parent and child perspectives provide unique, complementary information, as informant discordance carries meaningful clinical implications. Less is known about child-caregiver concordance in emotional and behavioral functioning among PICU survivors- a gap with direct implications for outcome measurement. This pilot study examined child-parent concordance in emotional and behavioral symptomatology following PICU admission in the long-term (M=12.8 months). Method/Data Selection: The sample included children (N=51; ages 10–18 years; M=14.8, SD=2.3) previously admitted to the PICU for brain-related health concerns. Emotional and behavioral functioning was assessed using congruent scales from the self and parent-report forms of the Behavior Assessment System for Children, 3rd Edition (BASC-3). Spearman (ρ) correlation assessed concordance. Significance defined as p< 0.05. Results/Data Synthesis: Moderate concordance was observed for depression (ρ=.56, p<.001) and attention problems (ρ=.52, p<.001). Significant but lower agreement was found for anxiety (ρ=.36, p=.01), hyperactivity (ρ=.36, p=.012), atypicality (ρ=.38, p=.007), and somatic complaints (ρ=.30, p=.045). Parent and child reports provided overlapping but non-redundant information, with notable discrepancies in somatic and internalizing domains. Conclusions: Findings highlight nuanced concordance between parent and child perspectives on post-PICU functioning. Moderate agreement supports integrating both reports in neuropsychological assessment and treatment planning. Discrepancies underscore the importance of capturing the child's lived experience, particularly for internalizing and somatic symptoms, informing rehabilitation and long-term neuropsychological care.