Linguistic and Cultural Diversity Considerations When Working With Families in a Pediatric Multidisciplinary Concussion Setting: A Case Study Illustration

Despite advances in pediatric brain injury care, the increasing demographic diversity in the USA is not well represented in the current literature. This case study describes a 15-year-old, Spanish/English bilingual, White Hispanic male who sustained a mild complicated traumatic brain injury (mTBI) when he fell off the back of a moving vehicle. Imaging revealed a left temporal bone fracture and epidural hemorrhage with midline shift requiring subsequent craniotomy for evacuation. He completed neurocognitive screening during visits to a multidisciplinary pediatric concussion clinic at 2.5- and 7.5-weeks post-injury. The patient demonstrated improvements in working memory from the first to the second clinic visit. The results of the neurocognitive screening were consistent with estimates of baseline functioning and suggestive of a positive recovery. However, there were still notable downstream effects from injury on his school re-integration and academic functioning. An overview of relevant factors in brain injury care when working with patients and families from culturally and linguistically diverse backgrounds is included. Recommendations for headache management, active rehabilitation, and school — including an Acute Concussion Evaluation (ACE) care plan — are discussed.