• Stephanie A Tesson, Rebecca R Nogajski, Julie-Anne Macey, and Simon P Paget.
• Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
• Emerg Med Australas. 2016 Feb 1; 28 (1): 73-7.

ObjectiveThis 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.MethodsParticipants 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.ResultsA 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.ConclusionsThe 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.© 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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