There is still much to learn about how mild traumatic brain injury (mTBI) presents in younger children and adolescents. Such as determining typical outcomes and course of recovery; as well as identifying wha t injury-related and non-injury related factors may predict outcomes and recovery. This presentation aims to present the methods and results of my research project ConICA - Which investigated the impact of concussion in children and adolescents.

Content will include reviewing existing models which outline the important factors considered to impact outcome and recovery following mTBI, and how this research project addressed some of the gaps in the field. Methods of the project will be presented, including an overview of assessments undertaken on 100 children and adolescents with concussion at the acute stage of injury (within 10 days), and at three months post-injury, as well as 50 control participants.

Results will also be presented, including the typical outcomes immediately following injury, and details regarding recovery up to three months post-injury, including ongoing cognitive difficulties and persistent symptoms. Comparisons made between subgroups will be summarised, comprising younger children (aged 6-10) and adolescents (aged 11-16), and sex (males and females). Finally, injury-related and non-injury related predictors of outcome will be discussed, including age and sex, and various other parent and child factors that have been considered to potentially impact outcome following mTBI.

In addition to presenting the typical outcomes, further goals of the presentation will be to highlight the importance of taking a holistic approach to concussion assessment, management, and treatment. This will include taking pre-injury and environmental factors into consideration, such as mood and behavioural functioning and parental anxiety.

Furthermore, the presentation will emphasise the importance of undertaking comprehensive neuropsychological testing and other well-validated assessments. This in turn may help guide future research into the impact of mTBI in children and adolescents, lead to better clinical management and treatment, and improve outcomes and recovery times.

Aim: This presentation aims to outline the clinical dilemmas and latest research findings surrounding the co-morbidity between Attention Deficit Hyperactivity Disorder (ADHD) and first-episode psychosis (FEP) — a co-morbidity that emerges during a critical window of neurodevelopmental and functional transition in late adolescence and young adulthood. A further aim is to open a collaborative dialogue with attendees about how clinical neuropsychology can advocate for and better support young people whose neurodevelopmental needs are frequently overlooked within psychiatric settings.

Content: This presentation is structured across three parts. In Part 1, the presenter will outline the basis of the ADHD-FEP relationship and two key clinical challenges: firstly, for individuals with a pre-existing ADHD diagnosis, psychosis onset disrupts continuity of care, with stimulant medication often discontinued or withheld, leaving young people without treatment they have relied upon to support daily functioning; and secondly, for those presenting with FEP who have longstanding but unrecognised ADHD, clinical management risks missing ADHD entirely, delaying accurate formulation and functional recovery. In Part 2, the presenter will share findings from his doctoral research, including the prevalence of ADHD in psychotic disorders, early psychosis clinicians' perspectives on assessing and treating ADHD, and a latent profile analysis of ADHD and psychosis symptom patterns — offering empirical insights that begin to address these challenges and their implications for clinical practice. In Part 3, the presenter will reflect on where clinical neuropsychology can contribute, particularly as the profession expands toward intervention alongside its established expertise in cognitive assessment and formulation, before inviting attendees to explore these ideas through a short, structured activity.

Goals: By the end of this presentation, attendees will be able to: (1) Identify the key clinical challenges that arise when ADHD and FEP co-occur, and recognise why this comorbidity is frequently missed or mismanaged; (2) Describe the current state of evidence regarding ADHD prevalence, clinician perspectives, and ADHD and FEP symptom profiles; and (3) Engage practically with how clinical neuropsychology, through assessment, formulation, and advocacy, can improve outcomes for young people in psychiatric settings.

Background: Children born moderate-to-late preterm (MLP; 32-36 weeks' gestation) are more likely to experience academic difficulties at school age compared with children born at term. It is unclear whether interventions targeting executive function (EF) could reduce this gap in academic achievement. This study examined the extent to which hypothetically improving EF could reduce the impact of MLP birth on academic achievement at age 9.

Methodology: Using a prospective longitudinal cohort design, 201 MLP and 201 full-term children (≥37 weeks; birthweight ≥2500g) were recruited at birth from The Royal Women's Hospital, Melbourne. At age 9, children completed neuropsychological assessment across EF subdomains (attentional control, cognitive flexibility, goal setting) and academic domains (word reading, phonetic decoding, spelling, mathematics). Total causal, interventional indirect and direct effects were estimated using a modern causal interventional framework, adjusting for baseline and intermediate confounders.

Results: Children born MLP performed worse in word reading (difference in means of −3.61; 95% confidence interval [CI] = −6.99, −0.24; p=.04), phonetic decoding (−3.92; 95% CI= −6.67, −1.16; p=.01), and mathematics (−3.94; 95% CI= −7.20, −0.68; p=.02) compared with children born at full term. Joint intervention on all three EF subdomains accounted for 32% of the achievement gap in word reading (absolute reduction of 1.14), 20% for phonetic decoding (absolute reduction of 0.8), 67% for mathematics (absolute reduction of 1.74) and 74% for spelling (absolute reduction of 2.64).

Conclusion: Interventions targeting EF may reduce the gap in academic performance between children born MLP and those born at full term. Interventions designed to improve EF skills should be considered, particularly when targeting mathematics, for children born MLP.

This research was conducted in collaboration with Prof Jeanie L. Y. Cheong, Prof Peter J. Anderson, Dr Rheanna M. Mainzer, Dr Melissa Middleton, Prof Lex W. Doyle, Prof Alicia J. Spittle, Dr Leona Pascoe, Dr Joy E. Olsen, and Dr Rachel Ellis.