What to do when your child has concussion.

Up to 30% of young people will experience a concussion before they turn 25. That’s a giant proportion of our young people having a dazed and confused moment.

But that’s all it is, right? A moment (or, at least, a day or two) of feeling a bit fuzzy, maybe throwing up a bit, and having a headache? That’s one of the most commonly held misconceptions about concussion.

And while there seems to be increasing media attention about the possible effects of these types of injuries (particularly in the sporting arena), it would seem that concussion is not well understood. Not just by the general public, either. Talk to a few doctors, or your child’s teachers, about what to expect in a child during the days, weeks and months following a concussion and I bet you’ll get a wide range of responses.

So, what’s the deal with concussion and are we supposed to be worried if our kids have one? This area of research has been controversial in the past, with some studies suggesting that kids can have ongoing problems after concussion with their behaviour, emotional functioning, intelligence, memory, attention levels and academic achievement. Other researchers have totally rejected that idea, and insist that concussion is nothing to worry about. Thankfully, it’s an area of research that seems to have gathered steam in the past few years. So the quality of the research being conducted is improving, and there’s more agreement amongst experts about what to expect after a bang on the head.

The consensus seems now to be that it’s not at all unusual for children to experience post-concussive symptoms for several weeks, or even a couple of months. Some of the most common symptoms in children are fatigue, headaches, irritability, behavioural changes, and mood symptoms. For most, these problems won’t last. But, for a minority of children, difficulties can be ongoing. And it seems that the kids who are most at risk of experiencing ongoing problems may be the same kids that were already experiencing other difficulties. Children with behaviour and learning issues, or those from poor or chaotic families, may unfortunately be at higher risk of experiencing complications in their recovery.

Which leads to that old chicken-egg problem; which came first, the problems or the injury? Does the injury simply perpetuate difficulties that the child was already having? Some of the changes that happen after concussion are so subtle, it can be pretty difficult even for experts (let alone parents) to work out what is going on for a child.

So, where does this leave us, as hypervigilant parents waiting for a child’s next injury? If it’s impossible to predict the effect that concussion might have on our precious little one’s life, and difficult to tell whether the concussion is to blame, then how are we supposed to deal with one when it comes along? Thankfully, in spite of this confusion, traumatic brain injury researchers are pretty united when it comes to recommendations for supporting a child after concussion. Some of my favourite tips for parents include:

1. Know what the symptoms of concussion are in children and seek medical advice

According to the World Health Organisation, if your child bangs their head (or even just gets a sudden jolt, like a whiplash – there doesn’t need to be direct force to the head), and if they have any of the following symptoms, then they meet criteria for a diagnosis of traumatic brain injury and should see a doctor immediately:

• Confusion or disorientation
• Loss of memory
• Loss of consciousness
• Any other symptom that could suggest neurological impact (e.g. speech changes, seizures, etc.)

Other concussion symptoms include nausea or vomiting, headaches, visual disturbances and fatigue.
Many people do not realise that concussion is a mild traumatic brain injury; fortunately, its effects are typically less severe than other brain injuries and most people will not require hospitalisation. Mild traumatic brain injuries, or concussions, are also much less likely to cause ongoing symptoms than more severe injuries..

2. Rest your child

A whole heap of parents have told me that they kept their child awake after a concussion as they were always told it was unsafe for a concussed person to sleep. Not true. Sleep is what they need! Yes, it’s a very good idea to monitor a person’s level of consciousness and assess whether there are any changes, but you can still let them sleep for the most part. Your child’s brain may be a little bruised and swollen and needs time to heal.

3. Reduce stimulation

It’s not just sleeping that they need – ideally, your child should have at least a few days of cognitive rest. That means, if possible, a quiet, low-stimuli environment. Keep them home from school and turn off the iPad and the TV wherever possible.

4. DON’T SEND THEM STRAIGHT BACK TO SPORT!

This one is really important. Your child should not return to playing sport for a few weeks, and if they are still demonstrating any post-concussive symptoms then it’s best that they don’t play at all until all symptoms are clear. Not only do they need to reduce physical activity to support their healing, returning to high-risk physical activities (like the playground or sports field) places them at risk of another injury. The more injuries they get, the more likely they are to have ongoing problems as a result of concussion. It may mean you sacrifice the sport season, which might seem like overkill – but this is your child’s brain and development that we’re talking about here. You have a right to prioritise your child’s health and wellbeing over the wants of a disappointed sports coach.

5. Communicate with school

Tell school what has happened and what symptoms your child has had. Ask them to monitor your child and communicate with you if they notice changes. If you think it’s necessary, ask for a short-term care plan to be put in place to adapt your child’s programme – it may be that they are unusually tired after lunch, for example, and need a nap or low-stress activity at that time.

6. If symptoms persist, seek advice and support

If you think that your child is still having problems three to six months after their concussion, it may be useful to get further support from a paediatrician or psychologist who specialises in traumatic brain injury. They can assess your child’s functioning and make recommendations as to how they can be supported, both at home and school.

7. Don’t worry

Remember, many kids get concussion and most do not experience ongoing effects. It helps to be aware that persistent problems are a possibility, but it probably doesn’t help to tie yourself up in knots about it. Let your child climb that tree and remember that, most of the time, the benefits of play outweigh the risks.


This article is an abridged version of one already published by The Hoopla - click here to see the original article, with thanks to The Hoopla.