Observation of your child’s symptoms and behaviors is crucial in diagnosing and managing head-related injuries.
No one wants their child to get a concussion while playing sports, but let’s face it – concussions do happen.
According to the CDC’s Youth Risk Behavior Survey, 9% of all high school athletes reported one sport-related concussion, and 3% reported two sport-related concussions over one year. (1) Another study showed that the concussion rate in high school athletes (9% of all injuries) was higher than that of college athletes (6%). (2)
Parents should be prepared. You know your child best. So your observation of their symptoms and behaviors is crucial in diagnosing and managing head-related injuries, including concussions.
In addition, there are so many myths and misconceptions about concussion management floating around the media. For example, you do not need to be waking up your concussed kid each hour of the night.
To combat misconceptions and help parents prepare, we have created a checklist of what to expect when your child gets a concussion. This checklist aligns with the CDC guidelines and Canada’s Parachute guidelines to ensure that you take the appropriate steps to mitigate risk and maximize your child’s recovery. (3,4)
Checklist for Parents of a Child with a Sport-Related Concussion
- Remove your child from play.
- The following are signs that parents can look for when they suspect their child may have sustained a head injury:
- Confusion
- Clumsy movement
- Lethargy
- Mood or behavior changes
- Loss of memory
- The CDC recommends: “When in doubt, sit them out.” (5). In other words, if you suspect your child has suffered a concussion, err on the side of caution and remove them from play.
- Do not return your child to play until they have been provided clearance by a qualified healthcare professional specializing in concussion management or knows your child (i.e., primary care provider).
- The following are signs that parents can look for when they suspect their child may have sustained a head injury:
- Have your child evaluated by a qualified healthcare professional as soon as possible.
- If an athletic trainer is available onsite, have them evaluate your child as soon as possible. The athletic trainer will also be able to help with referrals.
- Ideally, it would be best to have your child seen by a healthcare professional specializing in concussion management (i.e., athletic trainer or sports medicine physician).
- Have the following information available to provide to the healthcare professional:
- How the injury happened
- Symptoms that your child has experienced since the initial injury
- Abnormal complaints, behaviors, or mood changes
- Physical signs, such as balance or coordination issues
- Seek emergent care if your child’s symptoms worsen.
- The following signs and symptoms may indicate bleeding on the brain or more serious injury. Seek emergent care if one or more of the following are present:
- Slurred speech, weakness, numbness, or decreased coordination
- Excessive vomiting or nausea
- Drowsiness or inability to wake up
- Convulsions or seizures
- Unusual and growing behavior, confusion, restlessness, or agitation
- Loss of consciousness (knocked out)
- Neck pain
- The following signs and symptoms may indicate bleeding on the brain or more serious injury. Seek emergent care if one or more of the following are present:
- Follow the directions from the healthcare professional that evaluated your child.
- These directions may include:
- Ensuring your child is resting
- Monitoring their signs and symptoms daily
- Modifying school work and physical activity
- Monitoring and minimizing screen time
- These directions may include:
- Refer to additional specialized healthcare professionals, if needed.
- Based on the severity of your child’s concussion, you may be referred to more specialized care, such as:
- Sports medicine physicians or practitioners to provide sport-related guidance, and ultimately, medical clearance
- Neurologist to evaluate and treat neurological symptoms or when recovery is taking longer than anticipated
- Physical therapist to help your child restore symptom-free balance, coordination, and physical activity
- Based on the severity of your child’s concussion, you may be referred to more specialized care, such as:
- Allow time for your child to recover.
- Concussion recovery takes patience.
- Each concussion is unique. Recovery usually takes 1-4 weeks. If recovery takes longer than one month, your child may be referred for specialized care.
- Remember that your child’s brain is still developing, so allowing adequate time for recovery is crucial. Returning to sport too soon can severely delay recovery and increase the chances of sustaining another concussion.
- The most important thing to do for your child is to allow them to rest.
- Create an environment that optimizes recovery—for example, a dark room with no TV, loud noises, or flashing lights.
- Speak with the school nurse and administrators to make accommodations in school and homework, if needed. (You may need a “doctor’s note.” Your athletic trainer or physician should be able to help with this.)
- Have your child re-evaluated by a qualified healthcare professional who can make return-to-play decisions.
- Please do not allow your child to return to sport until they have received medical clearance.
- In most cases, the professional who can provide medical clearance will be your child’s physician, but this can vary from state to state in the U.S. Be sure to check your local state guidelines for who can and cannot provide medical clearance.
- Ask your healthcare provider about prescribing your child a gradual return-to-play protocol.
- Have your child participate in a gradual return-to-play protocol.
- Most return-to-play protocols involve a 6- or 7-step progression, with each step lasting a minimum of 24 hours. Your child must pass each step of the progression symptom-free to proceed to the next step. (6)
- These progressions include.
- Returning to school and sedentary activities
- Gradual return to physical activity (light to moderate to intense physical activity)
- Gradual return to sport (practice and contact training, then full competition)
- Decrease the risk of your child sustaining another concussion.
- After one concussion, the risk of sustaining another concussion increases. (7)
- Make sure your child’s helmet and equipment fit properly. Do not “size-up.”
- Have your child’s coach observe your child during play to make sure they’re using proper form. (For example, heads up during football tackles.)
- Ensure playing conditions are safe (proper mats for stunts, the padding on goalposts, etc.)
Following these steps will help you prepare and ensure that your child is in an optimal position for recovery:
- Remember that concussion recovery is unique to each child and takes time and patience.
- Seek care from only qualified healthcare professionals specialized in concussion management.
- As the CDC states: “when in doubt, sit them out” at any point throughout their recovery.
In addition to following this checklist, we recommend that you advocate for better concussion care at your child’s school. You can advocate two ways by requesting that the school: 1) hire at least one full-time athletic trainer and 2) provide mandatory concussion education and training to all coaches. These two items will go a long way in improving the recognition and management of concussions at your child’s school.
On a mission to prevent mismanaged concussions, HeadCheck Health provides end-to-end solutions to execute concussion protocols, mitigate risk, and promote recovery. Contact us today to learn how we can help!
References
- DePadilla L, Miller GF, Jones SE, Peterson AB, Breiding MJ. Self-Reported Concussions from Playing a Sport or Being Physically Active Among High School Students — United States, 2017. MMWR Morb Mortal Wkly Rep 2018;67:682–685. DOI: http://dx.doi.org/10.15585/mmwr.mm6724a3.
- Gessel LM, Fields SK, Collins CL, Dick RW, Comstock RD. Concussions among United States high school and collegiate athletes. J Athl Train. 2007;42(4):495-503.
- A Fact Sheet for High School Parents. CDC Heads Up. Accessed at: https://www.cdc.gov/headsup/pdfs/highschoolsports/parents_fact_sheet-a.pdf.
- Concussion Guide for Parents and Caregivers. Parachute Concussion Series. Accessed at: https://parachute.ca/wp-content/uploads/2019/06/Concussion-Guide-for-Parents-and-Caregivers.pdf.
- Responding to a Concussion and Action Plan for Coaches. Accessed at: https://www.cdc.gov/headsup/.
- Broglio SP, Cantu RC, Gioia GA, et al. National Athletic Trainers’ Association position statement: management of sport concussion. J Athl Train. 2014;49(2):245-265.
- Guskiewicz KM, McCrea M, Marshall SW, Cantu RC, Randolph C, Barr W, Onate JA, Kelly JP. Cumulative effects associated with recurrent concussion in collegiate football players: the NCAA Concussion Study. JAMA. 2003 Nov 19;290(19):2549-55. doi: 10.1001/jama.290.19.2549. PMID: 14625331.
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