child playing ice hockey

Concussion, Your Child and You

What every parent needs to know about concussion risk

Concussions can happen anywhere. From a fall on the playground to a hard hit on the field, accidents that result in a concussion are especially common in children. For parents, the most important thing you can do is not underestimate just how serious they can be.

Recognizing the symptoms and knowing the right steps to take are crucial to ensuring your child receives the proper care. John Leddy, MD, FACSM, FACP, a Professor of Clinical Orthopedics and Rehabilitation Sciences and Director of the University at Buffalo Concussion Management Clinic, explains the common symptoms of concussion, how to treat youth concussion properly and ensure your child returns to school and sports safely.

What is a concussion?

“A concussion is a temporary disturbance of brain function that occurs when traumatic forces are transmitted to the head, either directly or indirectly,” explains Dr. Leddy. This means that a concussion can occur from forces other than a direct blow to the head. A hit to the body can jostle the brain, causing it to collide with the skull and result in a concussion. But what makes concussions so scary for parents is that they aren’t always visible.

“Most concussions do not occur with loss of consciousness,” says Dr. Leddy. “In fact, concussion often occurs despite the individual not being unconscious. This is particularly true in sports, where loss of consciousness is unusual.”

What are the common symptoms of concussion?

Concussion results in the fairly rapid onset of a series of symptoms such as headache, dizziness, blurred vision, trouble with concentration, memory or balance. “A concussion typically evolves over a period of 24 hours or so, and it may continue to evolve or be persistent, depending on how bad the injury is,” Dr. Leddy states.

Symptoms of concussion are the same across age groups; children 10 and younger will experience the same symptoms as high school athletes. “What’s different is that children under 10 may not know how to articulate their symptoms,” says Dr. Leddy. “They’ll say, ‘I feel weird’ or ‘I’m tired,’ but they might not know how to express feeling more irritable, off-balance or recognize that their blurred vision is what’s giving them a headache. Young children have a hard time describing how severe their symptoms are because you need life experience to do that.”

My child is under 10, how can I tell if they have a concussion?

Keep an eye out for any changes in behavior.

“Anything out of the ordinary, such as being less active, more tired or more irritable, is important to note,” says Dr. Leddy.

Think about a possible cause of injury.

If your child just came back from football practice or was climbing on the jungle gym after school, they might have been injured there. “Inquire as to the possible mechanism of injury earlier in the day or the day before.”

Ask leading questions.

If you notice something’s off and know they were playing earlier, ask the child, “Hey, did you hit your head?” or “Did you fall down and bump your head, or did you get kicked in the head?” It’s important for parents to start the conversation since young children might not know what to say.

Dr. John Leddy quite about common cause of concussion in children under 10

What should I do if I think my child has a concussion?

“The first step is to make sure that the injury is not something more serious,” says Dr. Leddy. “If your child is saying, “My headache is really bad,” he or she is vomiting or isn’t answering questions appropriately, it may be a brain injury that is more severe than concussion and you need to take your child to the emergency room.” These symptoms could be the sign of something more severe such as bleeding in the brain.

However, if the symptoms are more standard, such as a personality change, non-worsening headache, feeling foggy or trouble with balance, an emergency room visit may not be necessary. “You can choose to bring your child to an ER or urgent care center if you’d prefer to–that’s OK!” he explains. “As long as things are not getting worse within the first 24 to 48 hours, a hospital visit is generally not necessary. At a minimum, however, within the next day or so bring the child to the primary care physician or to a concussion clinic in your area.”

How long should my child sit out of sports and school?

The first two days are crucial in terms of caring for children with concussion. “The first few days after a concussion are going to be difficult for the child or young adult, and school or other activities will only exacerbate their symptoms,” Dr. Leddy states. “Most kids with concussions should not go to school the first day or two immediately following the injury. Absolutely no sports during this period. We try to get kids back to school, with accommodations, as soon as possible after those first few days”

Staying home from school with a concussion does not mean lying in bed all day. “We don’t treat concussions by keeping patients in a dark room anymore,” he explains. “It’s better to move around, interact with others and perform low-level activities. Of course, they shouldn’t do anything that exacerbates their headache or dizziness. If anything makes their symptoms worse, they should stop and rest. Getting relative rest—which means staying below symptom-exacerbation thresholds—and taking it easy is important for the first 48 hours.”

Is screen time OK when a child is recovering from a concussion?

Once symptoms have stabilized or started to improve after the first few days, you can start to reintroduce activities to your child’s routine. “They can text their friends and have minimal screen time,” Dr. Leddy says, “but they shouldn’t be looking at a screen for an hour.” Kids should do things in small chunks of time, 10 or 15 minutes each, and take scheduled breaks. “I like the ‘15-5 rule’ for the first days after concussion: do cognitive activity for 15 minutes, or stop sooner if symptoms increase, and then take a 5 minute break. Keep repeating this cycle until you complete your task”.

How can I manage my child’s pain at home?

“Using Tylenol in the first few days is fine,” says Dr. Leddy. Try to avoid aspirin or other anti-inflammatories, as these can thin the blood. “Try not to use medicines more than four days a week. Taking headache medications too frequently can cause rebound headaches.”

Do helmets help prevent concussion?

There’s no scientific evidence to prove that helmets prevent concussions. “That doesn’t mean that your child doesn’t need to wear a helmet in football or hockey,” he says. “Helmets are very good at doing what they were designed for, and that’s preventing skull fractures. However, a helmet isn’t going to prevent the brain from getting shaken up. Any kid who hits his or her head while wearing a helmet during sports should be assessed and potentially treated for a concussion.”

How common are concussions in kids?

“The most common cause for concussions in children under 10 isn’t sport––it’s falling on the playground, falling off their bike or running into somebody at school,” Dr. Leddy explains. “On the other hand, sports are the number one cause of concussion in adolescents.”

It’s estimated that over half of student-athletes will sustain at least one concussion before they graduate high school. “The most dangerous thing an athlete can do is to continue to play with concussion symptoms or return to the playing field too soon, which puts them at increased risk of additional damage to the brain,” says Dr. Leddy. Educating children, coaches and parents about the signs and symptoms of a concussion is vital to ensure they are treated properly before returning to play.

For more breaking news and resources in the field of concussion, make sure to follow Concussion.Org on social media.