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"Some of the things that were restricted led to doing more arts and crafts together. I found out walking outside is great for concussion."
Spring sports season is a good time to review how to prevent and recognize concussions in children. Our “Now What?” series explores the definition, causes, and treatments for concussion.
The vast majority of concussions are mild or moderate and cause only headaches, light sensitivity, a need for extra sleep, or some moodiness for a few weeks. By following a doctor’s instructions regarding rest, limits on screen time, and reduced school work if needed, parents and caregivers can ensure that their child recovers within a relatively short period of time. In this article you’ll meet Christina, a caregiver to 7-year-old D’Angelo, who suffered a severe concussion that took extended time and therapy to resolve.
Is My Child Concussed?
Maybe your young athlete had a midfield collision. Maybe your daughter fell off her bike, or your son slipped in the bathroom. Maybe your child immediately seemed “off,” or maybe you didn’t realize something was wrong until they complained of a headache that wouldn’t go away.
A concussion is an injury to the brain caused by anything that makes the brain bounce or twist inside the skull. It is a kind of traumatic brain injury that can cause problems with coordination, memory, concentration, headaches, and other symptoms that often dissipate after a few weeks.
According to the Centers for Disease Control and Prevention, a concussion in children ages 5 to 9 prompted close to 60,000 emergency department visits per year between 2010 and 2016. Boys tend to have more concussions than girls; athletes and older children are also at higher risk.
A Playground Fall
When Christina got the call, she was on the other side of the city from the school her nephew attended. His teacher said D’Angelo had an accident on the playground, his head was bleeding, he was screaming, and they were taking him in an ambulance to the nearest emergency room.
“I rushed to the hospital,” recalls Christina, who is D’Angelo’s legal guardian. “I was just hoping nothing was permanent. He’s always had trouble in school, and I didn’t want anything to be worse for him.”
D’Angelo was one of the smallest kids in his first grade class. He had been running full speed across the blacktop at his Chicago elementary school when he collided with the biggest kid in his class. His head bounced on the asphalt.
By the time D’Angelo got to the emergency room, he was quiet. Normally, Christina says, he is extremely talkative, even in his sleep. But he wasn’t talking at all now. He fell asleep and had a CT scan. When he woke up he was a different child.
“He was very combative,” Christina recalls. “It was very scary.”
He had to be restrained so that a second ambulance could transport him to the nearest children’s hospital. For the first 12 hours after his accident, he could neither speak nor see. He stayed in the hospital for three days.
D’Angelo was diagnosed with a severe concussion. He missed the last quarter of school because of blurred and double vision, as well as persistent nausea and dizziness.
Christina hired a tutor for him over the summer so he wouldn’t fall too behind. Even so, the return to school was difficult. When second grade started, D’Angelo was in the thick of vision therapy and physical therapy.
“He was still having headaches,” Christina says. “He had some anger issues. He missed so much school that he really struggled academically. He was self-conscious because of being in the lowest reading group and not finishing assignments on time.”
Eleven months after his accident, D’Angelo’s MRI was clean and he had finished vision and physical therapies, but he still had headaches that caused irritability at school. He was assigned an aide, who monitored his behavior and gave him breaks when he needed them.
D’Angelo’s doctors warned Christina that he should not participate in any activity where he could hit his head again. A second concussion could be extremely dangerous for him. So to keep him active she signed him up for swim classes, which he enjoyed thoroughly until the pandemic started.
Concussions can result from any sharp jolt to the head, like a bump or fall, but also whiplash-type motions of the neck and shoulders.
After an accident, fall, or bump on the head, a child with concussion may:
Supports and Therapies
Experts recommend that children recovering from a mild concussion rest both physically and cognitively. They should maintain a regular sleep schedule, nap when they feel the need to, and avoid mentally taxing activities like schoolwork and using screens until their symptoms subside. They benefit from quiet activities like reading, playing with toys and puzzles at home, and walking outdoors. Above all, they should follow their doctor’s guidance while recovering.
For those injured during sports or suffering from a more severe injury, experts recommend beginning physical therapy as soon as a few days after the injury occurs. Physical therapists can aid young people to regain coordination, assist them with neck and shoulder pain from the accident, and help them overcome dizziness or vertigo.
Vision therapy is useful when a concussion has caused blurred or double vision or problems with reading or tracking. It can also help reduce post-concussion vertigo.
Most parents know that kids should wear a helmet when playing sports or doing other recreational activities like biking, rollerblading, or snowboarding. Lightweight helmets are even available for children playing sports like soccer where protective headgear is not traditionally used. Any helmet your child uses should fit well and be in good condition. Using the right size and kind of child safety seat in cars also protects them from head injury in the event of a collision.
Beyond these personal safety practices, parents can prevent head injuries by advocating for safer playground surfaces, like rubber mats or tiles, in their communities. Christina and other parents at her kids’ school petitioned their school district for a safer play surface. It was installed about 18 months after D’Angelo’s injury.
Advice for Parents
Christina wants other parents to know that it’s important to be patient with their child’s recovery and to take things one step at a time.
In some ways, slowing down was good for the whole family. Her son is three years younger than D’Angelo, and her teenage niece also lives with her.
“Some of the things that were restricted led to doing more arts and crafts together,” she says. “I found out walking outside is great for concussion. The doctor recommended up to a mile every day, so even with him being 7, we just walked to a local coffee place and back.”
Above all, she says, “Follow the advice of doctors and trust that things will be OK, even if they’re different forever. It’s just part of our new normal. It makes us more conscious and present.”