Information about Concussion for Parents and Caregivers
What is a Concussion?
A concussion is a mild injury to the brain that temporarily changes how the brain normally works. It is usually caused by a sudden blow or jolt to the head, although children often bump or hit their heads without getting a concussion. Signs and symptoms of a concussion can include dizziness, headache, vomiting, confusion, acting dazed, forgetting what happened before or after the injury, and being “knocked out.” A person does NOT need to be knocked out or lose consciousness to have had a concussion. Other words or terms for a concussion include mild traumatic brain injury (mild TBI) and mild closed-head injury.
What Should Parents Do in the First Days After a Concussion?
Serious problems after a concussion are rare, but can occur. For this reason, a medical doctor should always be involved in a young person’s care after a concussion. In the first 1-2 days after the injury, you should watch your child very carefully. You can give acetaminophen (Tylenol) for headaches, but no other medications should be given during this time without a doctor’s approval. You should get IMMEDIATE medical help if your child displays:
- a headache that gets worse, lasts for a long time, or is severe
- confusion, extreme sleepiness, or trouble waking up
- vomiting 3 or more times
- trouble walking or talking
- a seizure (arms or legs stiffen or shake uncontrollably)
- any other sudden change in thinking or behavior
What Should Generally be Expected?
Most young people will recover completely from a single concussion within two weeks. But, some people can take longer to recover than others. Common problems seen after a concussion are listed below. You should watch out for these problems. Talk with your child’s doctor about any changes that you notice in these areas:
Physical
- Headaches
- Sick to stomach or vomiting
- Dizziness or balance problems
- Low energy or being run down
- Trouble with vision/seeing
- Bothered by light or noise
- Sleeping problems
Thinking (Cognitive)
- Slowed thinking
- Trouble paying attention
- Difficulty remembering
- Acting like "in a fog"
- Easily confused
- School performance worsens
Behavioral or Emotional
- Irritability or grouchiness
- Easily upset or frustrated
- Nervousness
- Sadness
- Acting without thinking
- Any other personality change
Reasons to Consider Seeing Medical or Concussion Specialists Include:
- any of the above problems last more than two weeks
- any problem seems especially severe
- your child has had more than one concussion
- your child has been diagnosed with a more serious brain injury (e.g., a “moderate” or “severe” brain injury)
What Can Parents Do to Help?
A concussion can be scary and stressful for both you and your child. It’s important to remember that most problems will last for only a short time. The following suggestions should be helpful as your child is healing from the concussion:
- Keep your child safe. While problems caused by the concussion are still seen, it will be important that your child does not hit his or her head again. For a while, your child will probably need to take a break from sports and other activities that might cause another head injury. (More information about this topic is provided under the question, “When should young people play sports again?”)
- Have your child rest. Doing too much too soon after a concussion can make problems worse. In the first days after the concussion, don’t expect too much from your child. He or she will probably need lots of “down time” to rest and relax.
- Make sure your child gets enough sleep and eats properly. Some children will need more sleep than usual. Allowing naps during the day and making sure your child gets plenty of sleep at night should help. You should also make sure your child is eating healthy foods and drinking plenty of water.
- Allow extra time to finish things. Some children may be a little slower in how they do things. If so, allow more time than usual to finish tasks and make sure your child doesn’t feel pressure to get things done quickly.
- Give more chances to learn. Remembering things might be harder for a little while. When learning, make sure your child is first paying attention. He or she might also need to hear or see information more times than usual to learn it.
- Allow more breaks. Paying attention during hard or boring tasks might be difficult. If so, have your child take breaks when doing homework and other similar tasks.
- Be patient. After a concussion, your child might seem cranky, more easily upset, or more tired and forgetful. This behavior is probably being caused by the concussion. Try to be patient and understanding when this happens. If the behavior continues, talk with a doctor.
What Should be Done About School?
After a concussion, you should follow these steps to help with school:
1. Ask your child’s doctor when it will be okay for your child to go back to school. Most children are able to return to school within a few days of their injury. Some children benefit from returning to school slowly (e.g., for a few hours at first, then for a half day, then for a full day).
2. Tell your child’s school teacher, counselor, nurse, and administrators (e.g., principal) that your child had a concussion, even if the concussion happened over the summer.
3. Have the teacher and other school staff watch your child carefully for the next several weeks. They should look out for the common physical, thinking, and behavioral problems listed earlier.
4. If problems are seen, your child might need extra help at school. Talk with your child’s teacher to begin getting this help. If problems last more than a few weeks, a formal school plan should probably be developed. There are two types of formal school plans: a “Section 504 Plan” and an “Individualized Education Program” (IEP). Possible help that can be given to a student after a concussion includes:
- Student not asked to do all missed work, and extra help given to get caught back up
- Extra check-in meetings provided with teacher
- Rest time or breaks provided during the day
- Homework and class work lessened
- Assignments allowed to be turned in late
- Tests put off until student back to normal
- Extra time given to complete tests
- Special seating provided to help the student focus and so teacher can watch carefully
- Risky physical education and recess activities limited until student back to normal
- Indoor recess provided if needed
5. If problems at school last more than two weeks, your child should be checked by a team of healthcare and/or school professionals who know about concussion. Medical doctors should be asked about any physical problems (e.g., headaches, dizziness). A special type of evaluation called a neuropsychological assessment could also be useful, especially for any changes that are seen in thinking or behavior.
When Should Young People Play Sports Again or Return to Their Normal Physical Activities?
As long as your child is “symptomatic” – which means that any physical, thinking, or behavioral problems caused by the concussion are still seen – it is important that he or she not do anything that might cause another concussion. When there are still symptoms or problems, your child should NOT do any of the following until a medical doctor says it is okay:
- contact sports (football, hockey, soccer, rugby, wrestling, basketball, volleyball, etc.)
- riding a bike, scooter, motorcycle, ATV, 4-wheeler, or horse
- driving a car
- skateboarding, rollerblading, ice-skating
- snow or water skiing, snowboarding, sledding
- martial arts
- gymnastics
- jumping on a trampoline or any climbing activities (on playground equipment, trees, etc.)
- any other activity in which your child might hit his or her head
In some situations, neuropsychological or school-based testing can be useful after a concussion. However, these types of evaluations should NOT be used by themselves to decide whether a child is safe to return to play sports or do other physical activities. A medical doctor should always make this decision. When the doctor says it’s safe again, he or she should develop a specific plan to return your child to these activities in a step-by-step, gradual fashion.
Other Resources About Brain Injury for Parents
