• Cydni N Williams, Trevor A Hall, Victoria A Baker, Daniel J Chertow, W Michael Vanderlind, Christopher C Bosworth, and Mary E Hartman.
• Department of Pediatrics, Division of Pediatric Critical Care Medicine, Oregon Health & Science University, Portland, OR.
• Pediatr Crit Care Me. 2023 Oct 1; 24 (10): 807817807-817.

ObjectiveTo present the results of an abbreviated testing protocol used to screen for neurocognitive and psychological sequelae of critical illness among pediatric intensive care unit (PICU) survivors with acquired brain injury in our post-discharge follow-up programs, and describe our process for facilitating this population's return to academic life.DesignRetrospective cohort study.SettingNeurocritical care follow-up programs at two U.S. academic, tertiary medical/surgical PICUs.PatientsChildren age > 4 years enrolled in the neurocritical care follow-up programs (n=289) at these institutions who underwent neurocognitive and psychological testing between 2017-2021.InterventionsNone.Measurements And Main ResultsOne month after discharge from the hospital, nearly half of the children and/or their parents (48%) in our neurocritical care follow-up programs identified some type of emotional or behavioral concern compared to their premorbid state, and 15% reported some type of cognitive concern. On evaluation, 35% of the children were given a new neurocognitive diagnosis. Neurocognitive domains regulated by the executive functioning system were the most commonly affected, including attention (54%), memory (31%) and processing speed (27%). One-quarter of the children were given a new psychological diagnosis, most commonly post-traumatic stress disorder (PTSD) or stress-related symptoms (12%). Over 80% of patients in the programs were given new recommendations for school, for both new academic services and new classroom accommodations. Over half of children (57%) were referred for comprehensive follow-up neuropsychological evaluation.ConclusionsAbbreviated neurocognitive and psychological evaluation successfully identifies the same deficits commonly found among PICU survivors who undergo longer, more complete testing protocols. When combined with services aimed at successfully re-integrating PICU survivors back to school, this focused evaluation can provide an effective and efficient means of screening for cognitive and emotional deficits among PICU survivors, and establish a rationale for early academic support upon the child's return to school.

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