In a hot and crowded school gymnasium, two high school basketball players dive for a loose ball, hitting heads midair. The crowd goes silent; trainers and coaches rush to the players' aid.
For many parents, this is what a concussion looks and sounds like. It is dramatic and obvious, and it's why some young athletes are increasingly guided toward less physical sports. But the truth about concussions is they can be caused by any blow, bump, or jolt to the head -- whether it happens on the playing field or not.
State laws and awareness campaigns have established trainings and protocols for coaches and parents to follow when a young athlete suffers a potential concussion -- an athletic trainer is often on the sidelines to examine injuries and help determine if additional treatment is needed. Unfortunately, that same structured support is not in place for the many non-sports related instances when a child suffers a potential concussion, such as a fall down the stairs or a minor car accident.
There are two critical things parents, teachers and caregivers should do to prepare for potential injuries. The first is to become familiar with the signs and symptoms of a concussion, and the second is to consider every child at risk, regardless of whether they participate in sports. Failing to identify and seek care for injuries that occur in everyday life puts a child in danger of suffering additional injuries, which may lead to more severe symptoms over a longer period of time.
In some cases it is clear that a concussion has occurred, such as when a child loses consciousness after a fall. Other times, parents may have to play detective to identify a possible concussion, especially if the injury was not witnessed. For instance, if a child complains of new headaches or shows a change in sleeping pattern or more irritability, parents should ask their child what other symptoms they are experiencing and whether or not the child may have fallen or hit their head. Sometimes a child who initially appears okay after a fall or car accident will show more symptoms over the following days.
There is a constellation of common post-concussive symptoms that parents should keep in mind as possible red flags, including dizziness, light and noise sensitivity, and difficulty concentrating. Young children may have difficulty expressing these symptoms and they may simply manifest with changes in demeanor, such as a child being less interested in typical play activities.
Very young children fall often as they are learning to walk; while these falls rarely result in significant injury, a parent should be more alert for signs of concussion when a child falls from higher than their standing height.
The important point for parents to keep in mind is that concussions often cause noticeable changes in a child's behavior, and any such change should be taken seriously and investigated. If parents notice issues that are not consistent with a child's normal functioning, then it is best to reach out to a medical professional to get a proper evaluation.
When a child does suffer a concussion, it is essential to moderate their activities with the goal of protecting them from any additional injuries before they fully recover. Removing them from all typical activities isn't necessarily the answer, as that can harm the child's well-being, so it is important to work with a medical provider who can guide the family in managing the child's symptoms and navigating temporary accommodations for school when needed. Every child is different, and a recovery plan should be tailored to each child's individual needs.
When in doubt, remember that recreational activities such as gym class, climbing on playground equipment, and skateboarding can increase the risk for another injury. If there is any chance that a concussion has occurred, a child should be withheld from these kinds of activities until they are cleared by a medical professional.
Early detection of concussion can be a significant step toward shortening recovery time and preventing complications from a subsequent injury. It's important for parents to understand that concussion risk is not limited to the boundaries of a playing field. All parents should be prepared by knowing the symptoms of concussion and the importance of seeking care when a concussion may have occurred.
Dr. Suskauer is director of the Brain Injury Rehabilitation Programs at the Kennedy Krieger Institute. She is currently working on a traumatic brain injury study, funded by the Sports and Health Research Program, a partnership among the NIH, the National Football League, and the Foundation for the National Institutes of Health (FNIH), aimed at developing a tool to better understand the functioning of a child's brain after a concussion.