Millions of children sustain concussions every year but the exact number is hard to identify, as many cases go unreported. As a nurse working with children, I have seen quite a few of these injuries. As a mom, I’m concerned because there is current research suggesting the seriousness of such injuries to young, developing brains. Unfortunately, there is still so much about concussions that remain a mystery. But the general consensus is that multiple concussive injuries in childhood likely have long-term consequences into adulthood.
Concussions are not always the result of a blow to the head.
A concussion is a type of mild traumatic brain injury (mTBI). Do not be fooled by the word “mild,” as concussions become exponentially more risky with each subsequent one, and children need more recovery time than adults. A concussion occurs when there has been a jolting injury that causes the brain to forcefully hit the skull. There may or may not be a loss of consciousness, but there will be a change in consciousness. Symptoms may or may not be apparent at the time of the injury, or they may worsen over time. Humans have strong, resilient brains and most people recover within weeks from an initial concussion, with proper diagnosis and brain rest.
Kids are more likely to sustain concussions than adults.
We see a lot in the media about concussions among football players, and with good reason. There are more concussions among football players than any other contact sport. This is followed by soccer, hockey and basketball. According to Neuropsychologist Kim Gorgens, high school athletes are 3x more likely to sustain catastrophic brain injuries than college students. But sports only account for a fraction of concussions in children. Most concussions in children are caused by playground falls, bicycle riding and motor vehicle accidents.
There are steps you can take as a parent to prevent concussions.
If you’re like me you’ll be tempted to wrap your kids in high-quality bubble wrap and fit them for a helmet to wear 24/7. Don’t give in to these temptations! If you choose to allow your child to play contact sports, educate yourself on the safety equipment and recommendations of specialists who deal with childhood concussions. Get to know the culture, rules and regulations of the organization with which your kid is playing.
Make sure your child wears a helmet while bike riding, skateboarding, rollerblading and other similar activities. (This in itself doesn’t necessarily prevent concussions, but it prevents more damaging brain injuries.)
Use unexpired, properly installed car seats, and familiarize yourself with the instructions. The newest recommendations for car seats are to keep children rear-facing as long as possible, up until 4 years old, provided they meet the height and weight limits of your specific car seat.
Stay near children who are playing on the playground, and make sure they only play on age-appropriate equipment.
If you suspect your child may have a concussion, have him evaluated by a physician.
Take him to the ER if he exhibits the following symptoms: a severe or worsening headache, seizure, loss of consciousness, vomiting, slurred speech, loss of balance. If the symptoms are non-emergent, I suggest you contact your child’s pediatrician and have him evaluated within 24-72 hrs. She may be better able to diagnose a concussion than an ER because she knows your child. Even if your child doesn’t show signs of a concussion right away, keep an eye on him over the following weeks. If you notice changes in his behavior, mood, temperament, sleeping habits, memory or concentration, you should have him evaluated for a concussion.
I know, it’s not always easy to get kids to comply with the plan of care. Sometimes it can be downright frustrating. Whenever possible, involve them in the planning so they can feel a sense of control and responsibility. Engage your child in discussions with the physician on the significance of a concussion as a traumatic brain injury. If you know someone who has been through the same diagnosis, he or she may be a source of support for your child.
Another point to keep in mind, according to Dr. Jennifer McCain, a neuropsychologist from Tampa General Hospital, is that concussions are often overlooked when sustained with another injury, such as a broken arm.
What should you do if your child is diagnosed with a concussion?
First off, don’t panic. The vast majority of children recover from concussions with no further complications. You will work with your physician to create a plan of treatment for your child. Depending on the exact nature of the injury, this may include, but not be limited to, delaying return to school or sports, restricting digital devices, providing a quiet environment and decreased school work. Your child must be medically cleared in order to resume normal activities.
For more information about kids and concussions, check out the following links:
CDC Heads Up: Information sheets for parents, coaches and kids about head injuries.