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A concussion is a type of mild head injury, caused by trauma like a knock to the head. If your child has concussion, he’ll often need rest to allow his brain to recover. He’ll also need a gradual return to school, sport and other physical activity.

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About concussion

A concussion is a type of mild 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 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.

Thinking and remembering symptoms of concussion include:

  • difficulty concentrating
  • slower reaction times
  • difficulty remembering things, or even forgetting things altogether
  • feelings of being ‘in a fog’ or ‘slow’.

Emotional and behaviour symptoms of concussion include:

  • greater irritability than usual
  • anxiety
  • changes in mood like being sad or even depressed.

Concussion symptoms can take up to four weeks to go away, and sometimes even longer. But for most children, symptoms improve within several days.

Seizures, slurred speech or a loss of consciousness (blacking out) are symptoms of a moderate to severe head injury. If your child has any of these symptoms, call 000 for an ambulance immediately.

What to do if you think your child has concussion

If you think your child might have concussion, she must immediately stop what she’s doing or playing.

Your child needs to see a GP or team doctor (if available), or go to a hospital emergency department as soon as possible.

If your child has moderate to severe concussion symptoms, call an ambulance immediately.

It’s very important for your child to stop playing if there’s a chance he has a concussion. 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. 

Mental rest means limiting activities that need attention and concentration – for example, video games, texting, 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 go back to your doctor for further assessment.

Returning to school after concussion 

Most children can return to school when their symptoms have gone or when they can handle their 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. School staff might need to let you know if your child experiences any problems at school as a result.

Your child might need some support at school to start with. Support might include:

  • adjustments to timetables or classes
  • regular, frequent breaks in a quiet place between classes
  • extra time for schoolwork and assignments
  • help 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. This involves:

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

Returning to sport after concussion

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, gradual 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, like 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.

Your 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 concussion the first time. If you’re not sure about whether your child is OK to play, it’s best to take a careful approach.

Preventing concussion

There’s 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 like cycling helmets and mouthguards can prevent other injuries, but there’s little evidence that protective equipment reduces the risk of concussion.

The best way to help prevent concussion 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 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 for children.

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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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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