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Concussion

5-17 years

A concussion is a type of head injury. If your child has concussion, he needs rest to allow his brain to recover, and a gradual return to school, sport and other physical activity.

About concussion

A concussion is a type of head injury. It happens when the head gets bumped, which causes a short-term change in how the brain works.

The most common causes of concussion in young children are falls – for example, falling from a bed, couch, pram or some play equipment.

In older children, most concussions happen in sport – for example, Australian Rules football, rugby, soccer and horse riding. They also happen during leisure activities – for example, falls from bicycles or skateboards.

Signs and symptoms of concussion

Physical symptoms of concussion include:

  • headache
  • nausea and/or vomiting
  • blurred or double vision
  • sensitivity to light or noise
  • dizziness and balance problems
  • drowsiness, fatigue and sleep difficulties
  • seizures
  • loss of consciousness.

Cognitive symptoms of concussion include:

  • difficulty concentrating
  • difficulty remembering things, or even forgetting things altogether
  • feeling ‘in a fog’ or feeling ‘slow’.

Emotional and behaviour symptoms of concussion include feeling:

  • irritable
  • anxious
  • sad or even depressed.

For most children, concussion symptoms go away within two weeks. About one in five children and teenagers have symptoms that last for two weeks or more after concussion. A very few keep having symptoms for over a month after concussion.

What to do if you think your child has concussion

If you think your child might have concussion, she must stop playing immediately.

Your child needs to see a GP, sports doctor, neurologist or paediatrician as soon as possible. This can be done on the sideline (if it’s a sports-related concussion), in the emergency department of a hospital, or a doctor’s clinic.

If your child has severe symptoms – for example, seizures – call an ambulance by phoning 000.

Why your child must stop playing
Returning to play on the same day puts your child at greater risk of getting further injuries or more serious head injuries. This is because he might have slower reaction times, poor balance and slower thinking.

Treatment and management of concussion

The best treatment for concussion is physical and mental rest until acute symptoms have gone.

Mental rest means limiting activities that need attention and concentration – for example, video or electronic games, text messaging, reading, computer work and schoolwork. Try to keep your child’s thinking and brain activity low enough so that it doesn’t trigger symptoms.

While your child is having concussion symptoms, she’ll need someone to stay at home with her. This is to make sure she doesn’t do anything that increases her symptoms and slows her recovery.

If your child’s symptoms don’t go away within two weeks, it’s important to see a doctor for further assessment.

Returning to school after concussion
It’s best for your child to return to school only when acute symptoms have gone or when your child can handle the symptoms for more than 30 minutes during thinking activities.

It’s important for your child to return to school gradually. For example, your child could start by attending half a day at a time, and then later having a day off during the week if he’s getting very tired.

It’s also important to let school staff know that your child has had a concussion. This is because your child’s concentration, thinking and memory might be affected in the short term, and school staff might need to let you know if your child experiences any problems at school as a result. Also, your child might need some support at school to start with, such as:

  • adjusting your child’s timetable or classes
  • giving your child regular, frequent breaks in a quiet place between classes
  • giving your child extra time for schoolwork and assignments
  • helping your child with schoolwork.    

During this gradual return to school and normal schoolwork, your child needs to keep getting as much physical and mental rest as necessary by:

  • not playing any sport, including during breaks at school
  • sitting out active physical education classes
  • avoiding activities that risk further injury – for example, bike riding, skateboarding or rollerskating.

Returning to sport
Your child should return to sport only when she:

  • has returned to school full time
  • has returned to normal levels of thinking
  • can cope with schoolwork and light to medium exercise without concussion symptoms getting worse
  • is on a supervised return to play protocol.

Return to play protocol
A return to play protocol is a slow, graduated return to physical exercise after concussion. It generally involves the following steps:

  1. Get enough physical and mental rest until symptoms go away.
  2. Start light aerobic exercise, such as walking or swimming.
  3. Do simple sports drills and exercises with no risk of head impact – for example, running, side steps or bouncing a ball.
  4. Try more complex non-contact drills and exercises – for example, weaving, catching and passing. Light weight training can also start again now.
  5. Make a return to full-contact sport practice, only after medical clearance from a doctor.
  6. Return to normal, full-contact game play.

You child must have no symptoms at each step before he can move on to the next step. There should be at least 24 hours between each step.

If in doubt, sit it out. Your child is far more likely to get a second concussion within three months of having a concussion. If you’re not sure about whether your child is OK to play, it’s best to take a conservative approach.

Preventing concussion

There is a risk of concussion in many popular sports and activities, and there isn’t much you or your child’s sporting club can do to reduce this risk.

Protective equipment such as cycling helmets and mouthguards can prevent other injuries, but there is little evidence that protective equipment reduces the risk of concussions.

The best way to help prevent concussions is to teach and practise safe playing techniques and encourage fair play and respect among junior players.

How sports clubs and organisations respond to concussion

Sports clubs and organisations should have clear guidelines and protocols about concussion. Professional sports associations – for example, the Australian Football League (AFL) – often set up these guidelines.

It’s the responsibility of your child’s sports club to follow the guidelines.

Coaches, team managers and other club officials have a duty of care to your child and should be aware of and follow the relevant concussion guidelines for their sport.

Concussion guidelines usually outline the following:

  • what to do on the day of the game – for example, recognising the injury, checking symptoms, removing the child from play, and seeking medical advice
  • follow-up procedures – for example, following the sport’s or club’s return to play protocol.
It’s a good idea to check with your child’s sports club officials about the club’s concussion guidelines, find out who the club’s medical and first aid staff are, and check the club’s procedures for both game day and the follow-up period.

Long-term effects of concussion

We don’t know a lot about the long-term problems concussion can cause.

More severe early symptoms and multiple concussions within a short period of time – for example, six months – might place children at greater risk of having long-term problems with thinking and behaviour.

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Last updated or reviewed
28-11-2014

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Raising Children Network is supported by the Australian Government. Member organisations are the Parenting Research Centre and the Murdoch Childrens Research Institute with The Royal Children’s Hospital Centre for Community Child Health.

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