Skip to main content

Predicting Fatigue 12 Months after Child Traumatic Brain Injury: Child Factors and Postinjury Symptoms

  • Alison Crichton (a1) (a2) (a3), Ed Oakley (a1) (a4) (a5), Franz E Babl (a1) (a4) (a5), Mardee Greenham (a1) (a3), Stephen Hearps (a1), Carmel Delzoppo (a1) (a5), Miriam H. Beauchamp (a6) (a7), James S. Hutchison (a8) (a9) (a10), Anne-Marie Guerguerian (a8), Kathy Boutis (a8) (a10) and Vicki Anderson (a1) (a3) (a5)...

Objectives: Fatigue is a common and persisting symptom after childhood brain injury. This study examined whether child characteristics and symptomatology preinjury or 6 months postinjury (pain, sleep, and mood, inattention) predicted fatigue at 12months postinjury. Methods: Parents of 79 children (0–18 years) rated fatigue at 12 months after injury on a multidimensional scale (general, sleep/rest, and cognitive). Demographic and clinical data were collected at injury. Parents rated child sleep, pain, physical/motor function, mood, and inattention at injury (preinjury description), and 6 months postinjury. Children were divided into two traumatic brain injury severity groups: mild TBI (n=57) and moderate/severe TBI (n=27). Hierarchical regression models were used to examine (i) preinjury factors and (ii) symptoms 6 months postinjury predictive of fatigue (general, sleep/rest, and cognitive) at 12 months postinjury. Results: Sleep/rest fatigue was predicted by preinjury fatigue (7% of variance) and psychological symptoms preinjury (10% of variance). General fatigue was predicted by physical/motor symptoms (27%), sleep (10%) and mood symptoms (9%) 6 months postinjury. Sleep/rest fatigue was predicted by physical/motor symptoms (10%), sleep symptoms (13%) and mood symptoms (9%) 6 months postinjury. Cognitive fatigue was predicted by physical/motor symptoms (17%) 6 months postinjury. Conclusions: Preinjury fatigue and psychological functioning identified those at greatest risk of fatigue 12 months post-TBI. Predictors of specific fatigue domains at 12 months differed across each of the domains, although consistently included physical/motor function as well as sleep and mood symptoms postinjury. (JINS, 2018, 24, 224–236)

Corresponding author
Correspondence and reprint requests to: Alison Crichton, Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, Victoria, 3052, Australia. E-mail:
Hide All
Aaronson, L.S., Teel, C.S., Cassmeyer, V., Neuberger, G.B., Pallikkathayil, L., Pierce, J., & Wingate, A. (1999). Defining and Measuring Fatigue. Journal of Nursing Scholarship, 31(1), 4550.
Alfano, C.A., & Gamble, A.L. (2009). The Role of Sleep in Childhood Psychiatric Disorders. Child & Youth Care Forum, 38(6), 327340. doi: 10.1007/s10566-009-9081-y
Anderson, V., Catroppa, C., Haritou, F., Morse, S., Pentland, L., Rosenfeld, J., && Stargatt, R. (2001). Predictors of acute child and family outcome following traumatic brain injury in children. Pediatric Neurosurgery, 34(3), 138148. doi: 56009
Anderson, V., Le Brocque, R., Iselin, G., Eren, S., Dob, R., Davern, T., & Kenardy, J. (2012). Adaptive ability, behavior and quality of life pre and posttraumatic brain injury in childhood. Disability and Rehabilitation, 34(19), 16391647. doi: 10.3109/09638288.2012.656789
Anderson, V., Spencer-Smith, M., & Wood, A. (2011). Do children really recover better? Neurobehavioural plasticity after early brain insult. Brain, 134(8), 21972221. doi: 10.1093/brain/awr103
Ashman, T.A., Cantor, J.B., Gordon, W.A., Spielman, L., Egan, M., Ginsberg, A., & Flanagan, S. (2008). Objective measurement of fatigue following traumatic brain injury. The Journal Of Head Trauma Rehabilitation, 23(1), 3340. doi: 10.1097/01.HTR.0000308719.70288.22
Berrin, S.J., Malcarne, V.L., Varni, J.W., Burwinkle, T.M., Sherman, S.A., Artavia, K., && Chambers, H.G. (2007). Pain, fatigue, and school functioning in children with cerebral palsy: A path-analytic model. Journal of Pediatric Psychology, 32(3), 330337. doi: 10.1093/jpepsy/jsl017
Blinman, T.A., Houseknecht, E., Snyder, C., Wiebe, D.J., & Nance, M.L. (2009). Postconcussive symptoms in hospitalized pediatric patients after mild traumatic brain injury. Journal of Pediatric Surgery, 44(6), 12231228. doi: 10.1016/j.jpedsurg.2009.02.027
Briggs-Gowan, M., & Carter, A. (2006). Brief Infant Toddler Social Emotional Assessment. USA: Pearson Assessment.
Bushnik, T., Englander, J., & Wright, J. (2008). Patterns of fatigue and its correlates over the first 2 years after traumatic brain injury. Journal of Head Trauma Rehabilitation, 23(1), 2532. doi: 10.1097/
Cantor, J.B., Ashman, T., Bushnik, T., Cai, X., Farrell-Carnahan, L., Gumber, S., & Dijkers, M.P. (2014). Systematic review of interventions for fatigue after traumatic brain injury: A NIDRR traumatic brain injury model systems study. The Journal Of Head Trauma Rehabilitation, 29(6), 490497. doi: 10.1097/HTR.0000000000000102
Cantor, J.B., Gordon, W., & Gumber, S. (2013). What is post TBI fatigue? NeuroRehabilitation, 32(4), 875883. doi: 10.3233/NRE-130912
Carskadon, M.A., & Acebo, C. (2002). Regulation of sleepiness in adolescents: Update, insights, and speculation. Sleep, 25(6), 606614.
Carskadon, M.A., Acebo, C., & Jenni, O.G. (2004). Regulation of adolescent sleep: Implications for behavior. Annals of the New York Academy of Sciences, 1021, 276291. doi: 10.1196/annals.1308.032
Carter, B., Edwards, J., Kronenberger, W., Michalczyk, L., & Marshall, G. (1995). Case control study of chronic fatigue in pediatric patients. Pediatrics, 95(2), 179186.
Catroppa, C., Crossley, L., Hearps, S., Yeates, K.O., Beauchamp, M., Rogers, K., && Anderson, V. (2015). Social and behavioral outcomes: Preinjury to six months following childhood traumatic brain injury. Journal of Neurotrauma, 32(2), 109115. doi: 10.1089/neu.2013.3276
Catroppa, C., Godfrey, C., Rosenfeld, J., Hearps, S., & Anderson, V. (2012). Functional recovery ten years after pediatric traumatic brain injury: Outcomes and predictors. Journal of Neurotrauma, 29(16), 25392547. doi: 10.1089/neu.2012.2403
Chaudhuri, A., & Behan, P.O. (2000). Fatigue and basal ganglia. Journal of the Neurological Sciences, 179(S 1-2), 3442.
Chaudhuri, A., & Behan, P.O. (2004). Fatigue in neurological disorders. Lancet, 363(9413), 978988.
Crichton, A., Babl, F., Oakley, E., Greenham, M., Hearps, S., Delzoppo, C., & Anderson, V. (2016). Prediction of multi-dimensional fatigue following child brain injury. Journal of Head Trauma Rehabilitation, 32, 107116. doi: 10.1097/HTR.0000000000000248
Crichton, A., Knight, S., Oakley, E., Babl, F.E., & Anderson, V. (2015). Fatigue in child chronic health conditions: A systematic review of assessment instruments. Pediatrics, 135(4), e1015e1031. doi: 10.1542/peds.2014-2440
Crowley, S.J., Acebo, C., & Carskadon, M.A. (2007). Sleep, circadian rhythms, and delayed phase in adolescence. Sleep Medicine, 8(6), 602612. doi: 10.1016/j.sleep.2006.12.002
Dampier, C., Lieff, S., Lebeau, P., Rhee, S., McMurray, M., Rogers, Z., & Wang, W. (2010). Health-related quality of life in children with sickle cell disease: A report from the Comprehensive Sickle Cell Centers Clinical Trial Consortium. Pediatric Blood & Cancer, 55(3), 485494. doi: 10.1002/pbc.22497
de Leon, M.B., Kirsch, N.L., Maio, R.F., Tan-Schriner, C.U., Millis, S.R., Frederiksen, S., & Breer, M.L. (2009). Baseline predictors of fatigue 1 year after mild head injury. Archives of Physical Medicine and Rehabilitation, 90(6), 956965. doi: 10.1016/j.apmr.2008.12.016
Dennis, M., Yeates, K.O., Taylor, H.G., & Fletcher, J.M. (2007). Brain reserve capacity, cognitive reserve capacity, and age-based functional plasticity after congenital and acquired brain injury in children. In Y. Stern (Ed.), Cognitive reserve: Theory and applications (pp. 5383). Philadelphia, PA: Taylor & Francis.
Dewan, M.C., Mummareddy, N., Wellons, J.C. III, & Bonfield, C.M. (2016). Epidemiology of global pediatric traumatic brain injury: Qualitative Review. World Neurosurgery, 91, 497509. doi: 10.1016/j.wneu.2016.03.045
DiFazio, M., Silverberg, N.D., Kirkwood, M.W., Bernier, R., & Iverson, G.L. (2016). Prolonged activity restriction after concussion. Clinical Pediatrics, 55(5), 443451. doi: 10.1177/0009922815589914
Eddy, L., & Cruz, M. (2007). The relationship between fatigue and quality of life in children with chronic health problems: A systematic review. Journal for Specialists in Pediatric Nursing, 12(2), 105114. doi: 10.1111/j.1744-6155.2007.00099.x
Elovic, E. (2003). Anterior pituitary dysfunction after traumatic brain injury, part 1. Journal of Head Trauma Rehabilitation, 18, 541543.
Elovic, E. (2004). Anterior pituitary dysfunction after traumatic brain injury, Part 2. Journal of Head Trauma Rehabilitation, 19, 184187.
Elovic, E., Dobrovic, N.M., & Fellus, J.L. (2007). Fatigue after traumatic brain injury. In J. Deluca (Ed.), Fatigue as a window to the brain (pp. 89106). Cambridge, MA: MIT Press.
Elovic, E., Doppalapudi, H.S., Miller, M., DeLuca, J., Masel, B.E., Fellus, J.L., && Urban, R.J. (2006). Endocrine abnormalities and fatigue after traumatic brain injury. Journal of Head Trauma Rehabilitation, 21(5), 426427.
Ewing-Cobbs, L., Bloom, D.R., Prasad, M.R., Waugh, J.K., Cox, C.S. Jr., & Swank, P.R. (2014). Assessing recovery and disability after physical trauma: The pediatric injury functional outcome scale. Journal of Pediatric Psychology, 39(6), 653665. doi: 10.1093/jpepsy/jsu018
Falk, A.-C. (2013). A nurse-led paediatric head injury follow-up service. Scandinavian Journal of Caring Sciences, 27(1), 5156. doi: 10.1111/j.1471-6712.2012.00999.x
Finsterer, J., & Mahjoub, S.Z. (2014). Fatigue in healthy and diseased individuals. American Journal of Hospice & Palliative Medicine, 31(5), 562575. doi: 10.1177/1049909113494748
Gagner, C., Landry-Roy, C., Lainé, F., & Beauchamp, M.H. (2015). Sleep-wake disturbances and fatigue following pediatric traumatic brain injury: A systematic review of the literature. Journal of Neurotrauma, 32(20), 15391552. doi: 10.1089/neu.2014.3753
Garcia, D., Hungerford, G.M., & Bagner, D.M. (2015). Topical review: Negative behavioral and cognitive outcomes following traumatic brain injury in early childhood. Journal of Pediatric Psychology, 40(4), 391397. doi: 10.1093/jpepsy/jsu093
Gedaly-Duff, V., Lee, K.A., Nail, L.M., Nicholson, H.S., & Johnson, K.P. (2006). Pain, sleep disturbance, and fatigue in children with leukemia and their parents: A pilot study. Oncology Nursing Forum, 33(3), 641646. doi: 10.1188/06.onf.641-646
Gibson, F., Garnett, M., Richardson, A., Edwards, J., & Sepion, B. (2005). Heavy to carry: A survey of parents’ and healthcare professionals’ perceptions of cancer-related fatigue in children and young people. Cancer Nursing, 28(1), 2735.
Gold, J.I., Mahrer, N.E., Yee, J., & Palermo, T.M. (2009). Pain, fatigue, and health-related quality of life in children and adolescents with chronic pain. Clinical Journal of Pain, 25(5), 407412. doi: 10.1097/AJP.0b013e318192bfb1
Goodman, R. (2001). Psychometric properties of the Strengths and Difficulties Questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry, 40(11), 13371345.
Goodman, R., Ford, T., Simmons, H., Gatward, R., & Meltzer, H. (2000). Usingng the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. British Journal of Psychiatry, 177, 534539.
Goodman, R., Renfrew, D., & Mullick, M. (2000). Predicting type of psychiatric disorder from Strengths and Difficulties Questionnaire (SDQ) scores in child mental health clinics in London and Dhaka. European Child and Adolescent Psychiatry, 9, 129134.
Gordijn, M.S., van Litsenburg, R.R., Gemke, R.J., Huisman, J., Bierings, M.B., Hoogerbrugge, P.M., && Kaspers, G.J. (2013). Sleep, fatigue, depression, and quality of life in survivors of childhood acute lymphoblastic leukemia. Pediatric Blood & Cancer, 60(3), 479485. doi: 10.1002/pbc.24261
Gregory, A.M., & Sadeh, A. (2012). Sleep, emotional and behavioral difficulties in children and adolescents. Sleep Medicine Reviews, 16(2), 129136. doi: 10.1016/j.smrv.2011.03.007
Gregory, A.M., & Sadeh, A. (2016). Annual research review: Sleep problems in childhood psychiatric disorders - A review of the latest science. Journal of Child Psychology & Psychiatry, 57(3), 296317. doi: 10.1111/jcpp.12469
Grover, S.A., Aubert-Broche, B., Fetco, D., Collins, D.L., Arnold, D.L., Finlayson, M., & Yeh, E.A. (2015). Lower physical activity is associated with higher disease burden in pediatric multiple sclerosis. Neurology, 85(19), 16631669. doi: 10.1212/wnl.0000000000001939
Harrison, P.L., & Oakland, T. (2003). Adaptive behavior assessment system-second edition. San Antonio, TX: The Psychological Corporation.
Hassett, L.M., Moseley, A.M., Tate, R.L., Harmer, A.R., Fairbairn, T.J., & Leung, J. (2009). Efficacy of a fitness centre-based exercise programme compared with a home-based exercise programme in traumatic brain injury: A randomized controlled trial. Journal of Rehabilitation Medicine, 41(4), 247255. doi: 10.2340/16501977-0316
Hinds, P.S., Nuss, S.L., Ruccione, K.S., Withycombe, J.S., Jacobs, S., DeLuca, H., & DeWalt, D.A. (2013). PROMIS pediatric measures in pediatric oncology: Valid and clinically feasible indicators of patient-reported outcomes. Pediatric Blood & Cancer, 60(3), 402408. doi: 10.1002/pbc.24233
Hooper, S.R., Alexander, J., Moore, D., Sasser, H.C., Laurent, S., King, J., & Callahan, B. (2004). Caregiver reports of common symptoms in children following a traumatic brain injury. NeuroRehabilitation, 19(3), 175189.
Iglowstein, I., Jenni, O.G., Molinari, L., & Largo, R.H. (2003). Sleep duration from infancy to adolescence: Reference values and generational trends. Pediatrics, 111(2), 302307.
Ivanenko, A., Crabtree, V.M., & Gozal, D. (2005). Sleep and depression in children and adolescents. Sleep Medicine Reviews, 9(2), 115129. doi: 10.1016/j.smrv.2004.09.006
Karabekiroglu, K., Briggs-Gowan, M.J., Carter, A.S., Rodopman-Arman, A., & Akbas, S. (2010). The clinical validity and reliability of the Brief Infant-Toddler Social and Emotional Assessment (BITSEA). Infant Behavior & Development, 33(4), 503509. doi: 10.1016/j.infbeh.2010.07.001
Kluger, B.M., Krupp, L.B., & Enoka, R.M. (2013). Fatigue and fatigability in neurologic illnesses: Proposal for a unified taxonomy. Neurology, 80(4), 409416. doi: 10.1212/WNL.0b013e31827f07be
Limond, J., Dorris, L., & McMillan, T.M. (2009). Quality of life in children with acquired brain injury: Parent perspectives 1-5 years after injury. Brain Injury, 23(7), 617622. doi: 10.1080/02699050902997870
Lofthouse, N., Gilchrist, R., & Splaingard, M. (2009). Mood-related sleep problems in children and adolescents. Child and Adolescent Psychiatric Clinics of North America, 18(4), 893916. doi: 10.1016/j.chc.2009.04.007
Looman, W.S., Thurmes, A.K., & O’Conner-Von, S.K. (2010). Quality of life among children with velocardiofacial syndrome. Cleft Palate-Craniofacial Journal, 47(3), 273283. doi: 10.1597/09-009.1
MacAllister, W.S., Christodoulou, C., Troxell, R., Milazzo, M., Block, P., Preston, T.E., & Krupp, L.B. (2009). Fatigue and quality of life in pediatric multiple sclerosis. Multiple sclerosis (Houndmills, Basingstoke, England), 15(12), 15021508. doi: 10.1177/1352458509345902
Marcus, S.B., Strople, J.A., Neighbors, K., Weissberg-Benchell, J., Nelson, S.P., Limbers, C., & Alonso, E.M. (2009). Fatigue and health-related quality of life in pediatric inflammatory bowel disease. Clinical Gastroenterology and Hepatology, 7(5), 554561.
Mears, C.J., Taylor, R.R., Jordan, K.M., & Binns, H.J. (2004). Sociodemographic and symptom correlates of fatigue in an adolescent primary care sample. The Journal of Adolescent Health, 35(6), 528e.521526. doi: 10.1016/j.jadohealth.2004.02.012
Meeske, K., Katz, E.R., Palmer, S.N., Burwinkle, T., & Varni, J.W. (2004). Parent proxy-reported health-related quality of life and fatigue in pediatric patients diagnosed with brain tumors and acute lymphoblastic leukemia. Cancer, 101(9), 21162125. doi: 10.1002/cncr.20609
Mindell, J.A., Owens, J.A., & Carskadon, M.A. (1999). Developmental features of sleep. Child and Adolescent Psychiatric Clinics of North America, 8(4), 695725.
Mollayeva, T., Kendzerska, T., Mollayeva, S., Shapiro, C.M., Colantonio, A., & Cassidy, J.D. (2014). A systematic review of fatigue in patients with traumatic brain injury: The course, predictors and consequences. Neuroscience and Biobehavioral Reviews, 47, 684716. doi: 10.1016/j.neubiorev.2014.10.024
Norrie, J., Heitger, M., Leathem, J., Anderson, T., Jones, R., & Flett, R. (2010). Mild traumatic brain injury and fatigue: A prospective longitudinal study. Brain Injury, 24(13-14), 15281538. doi: 10.3109/02699052.2010.531687
Panepinto, J.A., Torres, S., Bendo, C.B., McCavit, T.L., Dinu, B., Sherman-Bien, S., & Varni, J.W. (2014). PedsQ Multidimensional Fatigue Scale in sickle cell disease: Feasibility, reliability, and validity. Pediatric Blood & Cancer, 61(1), 171177. doi: 10.1002/pbc.24776
Pattyn, N., Neyt, X., Henderickx, D., & Soetens, E. (2008). Psychophysiological investigation of vigilance decrement: Boredom or cognitive fatigue? Physiology and Behavior, 93(1-2), 369378. doi: 10.1016/j.physbeh.2007.09.016
Ponsford, J., Schönberger, M., & Rajaratnam, S.M.W. (2014). A model of fatigue following traumatic brain injury. Journal of Head Trauma Rehabilitation, 30, 277282. doi: 10.1097/HTR.0000000000000049
Ponsford, J., & Sinclair, K. (2014). Sleep and fatigue following traumatic brain injury. The Psychiatric Clinics Of North America, 37(1), 7789. doi: 10.1016/j.psc.2013.10.001
Reed, N., Greenspoon, D., Iverson, G.L., DeMatteo, C., Fait, P., Gauvin-Lepage, J., & Gagnon, I. (2015). Management of persistent postconcussion symptoms in youth: A randomised control trial protocol. BMJ Open, 5(7), e008468. doi: 10.1136/bmjopen-2015-008468
Ross, K.A., Dorris, L., & McMillan, T.O.M. (2011). A systematic review of psychological interventions to alleviate cognitive and psychosocial problems in children with acquired brain injury. Developmental Medicine and Child Neurology, 53(8), 692701. doi: 10.1111/j.1469-8749.2011.03976
Schönberger, M., Herrberg, M., & Ponsford, J. (2014). Fatigue as a cause, not a consequence of depression and daytime sleepiness: A cross-lagged analysis. The Journal of Head Trauma Rehabilitation, 29, 427431. doi: 10.1097/HTR.0b013e31829ddd08
Spencer-Smith, M., & Anderson, V. (2011). Plasticity in a pediatric population. In A.S. Davis (Ed.), Handbook of pediatric neuropsychology (pp. 177189). New York, NY: Springer Publishing Co.
StataCorp. (2015). Stata Statistical Software: Release 14. College Station, TX: StataCorp LP.
Stone, L.L., Otten, R., Engels, R.C., Vermulst, A.A., & Janssens, J.M. (2010). Psychometric properties of the parent and teacher versions of the strengths and difficulties questionnaire for 4- to 12-year-olds: A review. Clinical Child and Family Psychology Review, 13(3), 254274. doi: 10.1007/s10567-010-0071-2
Sumpter, R., Brunklaus, A., McWilliam, R., & Dorris, L. (2011). Health-related quality-of-life and behavioural outcome in survivors of childhood meningitis. Brain Injury, 25(13/14), 12881295. doi: 10.3109/02699052.2011.613090
Sundström, A., Nilsson, L.G., Cruts, M., Adolfsson, R., Van Broeckhoven, C., & Nyberg, L. (2007). Fatigue before and after mild traumatic brain injury: Pre-postinjury comparisons in relation to Apolipoprotein E. Brain Injury, 21(10), 10491054. doi: 10.1080/02699050701630367
Taylor, H.G. (2010). Neurobehavioral outcomes of pediatric traumatic brain injury. In V. Anderson & K.O. Yeates (Eds.), Pediatric traumatic brain injury: New frontiers in clinical and translational research (pp. 145168). Cambridge: Cambridge University Press.
Taylor, H.G., Swartwout, M., Yeates, K.O., Walz, N.C., Stancin, T., & Wade, S. (2008). Traumatic brain injury in young children: Post-acute effects on cognitive and school readiness skills. Journal of the International Neuropsychological Society, 14(5), 734745. doi: 10.1017/S1355617708081150
Teasdale, G., & Jennett, B. (1974). Assessment of coma and impaired consciousness. A practical scale. Lancet, 2(7872), 8184.
ter Wolbeek, M., van Doornen, L.J., Kavelaars, A., & Heijnen, C.J. (2008). Predictors of persistent and new-onset fatigue in adolescent girls. Pediatrics, 121(3), e449e457. doi: 10.1542/peds.2007-1093
van Zomeren, A.H., Brouwer, W.H., & Deelman, B.G. (1984). Attentional deficits: The riddles of selectivity, speed and alertness. In D. Brooks (Ed.), Closed head injury: Psychological, social and family consequences. Oxford: Oxford University Press.
Varni, J.W., Beaujean, A.A., & Limbers, C.A. (2013). Factorial invariance of pediatric patient self-reported fatigue across age and gender: A multigroup confirmatory factor analysis approach utilizing the PedsQL™ Multidimensional Fatigue Scale. Quality of Life Research, 22(9), 25812594. doi: 10.1007/s11136-013-0370-4
Varni, J.W., Burwinkle, T.M., Berrin, S.J., Sherman, S.A., Artavia, K., Malcarne, V.L., && Chambers, H.G. (2006). The PedsQL in pediatric cerebral palsy: Reliability, validity, and sensitivity of the Generic Core Scales and Cerebral Palsy Module. Developmental Medicine and Child Neurology, 48(6), 442449. doi: 10.1017/S001216220600096X
Varni, J.W., Burwinkle, T.M., Katz, E.R., Meeske, K., & Dickinson, P. (2002). The PedsQL in pediatric cancer: Reliability and validity of the Pediatric Quality of Life Inventory Generic Core Scales, Multidimensional Fatigue Scale, and Cancer Module. Cancer, 94(7), 20902106.
Varni, J.W., Burwinkle, T.M., & Szer, I.S. (2004). The PedsQL Multidimensional Fatigue Scale in pediatric rheumatology: Reliability and validity. Journal of Rheumatology, 31(12), 24942500.
Varni, J.W., Limbers, C.A., Bryant, W.P., & Wilson, D.P. (2009). The PedsQL Multidimensional Fatigue Scale in type 1 diabetes: Feasibility, reliability, and validity. Pediatric Diabetes, 10(5), 321328. doi: 10.1111/j.1399-5448.2008.00482.x
Varni, J.W., Limbers, C.A., Bryant, W.P., & Wilson, D.P. (2010). The PedsQ Multidimensional Fatigue Scale in pediatric obesity: Feasibility, reliability and validity. International Journal of Pediatric Obesity, 5(1), 3442. doi: 10.3109/17477160903111706
Varni, J.W., Seid, M., & Kurtin, P.S. (2001). PedsQL 4.0: Reliability and validity of the Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales in healthy and patient populations. Medical Care, 39(8), 800812.
Varni, J.W., Seid, M., & Rode, C.A. (1999). The PedsQL: measurement model for the pediatric quality of life inventory. Medical Care, 37(2), 126139.
Viner, R.M., Clark, C., Taylor, S.J., Bhui, K., Klineberg, E., Head, J., & Stansfeld, S.A. (2008). Longitudinal risk factors for persistent fatigue in adolescents. Archives of Pediatrics and Adolescent Medicine, 162(5), 469475. doi: 10.1001/archpedi.162.5.469
Yeates, K.O., Taylor, H.G., Rusin, J., Bangert, B., Dietrich, A., Nuss, K., & Jones, B.L. (2009). Longitudinal trajectories of postconcussive symptoms in children with mild traumatic brain injuries and their relationship to acute clinical status. Pediatrics, 123(3), 735743. doi: 10.1542/peds.2008-1056
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Journal of the International Neuropsychological Society
  • ISSN: 1355-6177
  • EISSN: 1469-7661
  • URL: /core/journals/journal-of-the-international-neuropsychological-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed