The Richmond Register

February 14, 2014

When the knock on the noggin is a cause for concern

By Dan Florell and Praveena Salins
Register Columnists

RICHMOND — A girl is furiously dribbling the ball up the court in a middle school girls’ basketball game. A player tries to catch her from behind but instead trips the girl. The girl’s head bounces twice on the floor before coming to rest.

The girl just lays on the floor as various adults come rushing to her aid. The girl is able to get up but is unsteady on her feet as she walks toward the bench.

The above scenario has been a common occurrence in many sports that children and adolescents play. If this was to have happened even 10 years ago, the girl would have sat on the bench until she felt ok and then would have been put back into the game. That has changed over the past few years as the true impact of concussions on child and adolescent brain development has become more evident.

While it can be easy to spot some concussions such as the situation above, others can be more subtle and take hours to days to show up after the injury.

Some common symptoms of concussions include headaches, nausea, vomiting, dizziness, trouble concentrating, being confused and having trouble remembering. If a concussion is suspected, then the child or adolescent needs to immediately stop playing until a medical professional can be seen.

As a parent or coach, it can be difficult to remember all of the symptoms of a concussion. Fortunately, there are many apps for concussions that people can use on their smart phones. These apps typically have a checklist that can be used to discern if a concussion is likely to have occurred.

One free app for assessing concussions is the Concussion Recognition and Response app. While no app should take the place of a child or adolescent seeing a medical professional, it can provide some initial guidance. These apps are more effective if a prescreening is conducted so a baseline of the child or adolescent’s normal functioning can be established.

Once a concussion has been confirmed, a child or adolescent needs to receive complete rest from all physical and mental activity. This is due to the increased risk of having another concussion if they are not given time to heal.

Most people realize that children and adolescents who have concussions should be excused from physical activities like recess and gym but don’t realize that mental activity should also be curtailed.

Curtailed mental activity at school means less than 10 pages of reading and less than an hour of total homework, online activity and video games. In addition, loud music and television should be stopped particularly if they increase concussion symptoms. If children or adolescents ignore this advice and maintain a full schedule then they are more likely to extend the time it takes for them to fully recover from the concussion.

All concussions are not the same and each one needs to be treated individually. In general, a child or adolescent should return to school when the concussion symptoms have lessened and are tolerable for 30 to 45 minutes. This typically occurs with a few days to a week after a concussion. Of course, always consult with a medical professional throughout the recovery process and remember that it is better to be cautious when treating a concussion. 

Dan Florell, Ph.D., is an assistant professor at Eastern Kentucky University and has a private practice, MindPsi (www.mindpsi.net). Praveena Salins, M.D., is a pediatrician at Madison Pediatric Associates (www.madisonpeds.com).