What is a concussion?
A concussion is a brain injury caused when the brain moves rapidly back and forth inside the skull. It can cause a variety of symptoms and may affect the way your child thinks or acts. Most concussions do not include a loss of consciousness.

 

What causes a concussion?

A concussion can be caused directly by a hit to the head, or indirectly by a hit to the body that causes a sudden jerk of the head or neck. Any force that causes the brain to move around in the skull can result in a concussion.

 

How serious is a concussion?

Any head injury needs to be taken seriously. Most concussions, managed appropriately, resolve without complications. On rare occasions, concussion injuries can be more serious and result in long term disabilities.The real dangers of most concussions occur when the injury is not recognized or is managed incorrectly. Returning to activities too early can put a child at increased risk for future concussions and serious complications.If a person has another concussion, the effects can be worse and result in more serious complications. Second impact syndrome is a rare but typically fatal injury that may result if a person sustains another concussion before their brain has healed.

Managing a child with a concussion

 

A concussion is a mild brain injury and can be difficult to manage. The long term health of a child who has sustained a concussion is dependent on a management team of athletes, coaches, referees, school staff, physicians and parents. As a parent you have an important role in each stage of managing your child’s concussion. Your position as the central caregiver is critical to your child’s recovery.If you suspect your child has a concussion, check for Red Flag Symptoms immediately and review the steps on the

Concussion Response Tool

For more information take the Concussion Awareness Course

 

Concussion Facts

  • Concussions do not always include a loss of consciousness
  • Helmets DO NOT protect against concussions
  • A child does not need to be hit in the head to sustain a concussion
  • The signs and symptoms of a concussion can be delayed up to weeks post injury
Does my child have a concussion?

If your child shows any of the Red Flag Symptoms call 911 immediately.

Did your child have a hit to the head or blow to the body?

You should consider your child to have a concussion if you or someone else has witnessed, or you suspect that, your child has had either a hit to the head or a hit to the body that caused a sudden jerk to the neck or head.

Even if your child shows no obvious signs of having a concussion, if they have had an incident, you should seek medical attention as soon as possible.

Does your child have signs and symptoms of a concussion?

Signs and symptoms of a concussion can be delayed for several hours or even days following an incident. Following is a list of signs and symptoms consistent with a concussion.

Thinking and Remembering Physical Emotional and Mood Sleep
Not thinking clearly Headache Easily upset or angered Sleeping more
Feeling slowed down Fuzzy or blurry vision Sad Sleeping less
Unable to concentrate Nausea and vomiting Nervous or anxious Having a hard time falling asleep
Unable to remember new information Dizziness More emotional Sensitivity to light or noise
Balance problems
Feeling tired or having no energy

If your child is showing any of these signs and symptoms then you should take your child to the doctor to investigate further. If your child has had a past concussion incident, even a minor hit to the head or body can trigger symptoms.

Signs and symptoms of concussion in an infant or toddler:

Concussion signs and symptoms to watch for in your infant/toddler include:

  • Crankiness and irritability (beyond their usual)
  • Any sudden changes in sleeping patterns, eating or playing pattern
  • Not interested in their favourite toys or activities
  • Forgets a new skill (e.g. toilet training)
  • Listless
  • Loss of balance, unsteady walking
  • Not eating or nursing
  • Cannot be comforted

Seek medical attention if your infant/toddler is showing behaviour that is unusual for them or concerns you.

Concussion Response Tool

The Concussion Response Tool was developed to assist coaches and parents to recognize and respond to concussions. The first two pages outline how to respond to a concussion at the time of the incident. The third page provides important information for parents who are caring for their child at home after the incident.

The Concussion Response Tool can also serve as an important communication tool for sharing information from the scene of the incident.

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What do I do if I think my child has a concussion?

What do I do if I think my child has a concussion?

If your child shows any of the Red Flag Symptoms call 911 immediately. If you suspect your child has sustained a concussion seek medical attention as soon as possible. Monitor your child until they can be seen by a doctor. Do not leave your child alone. Do not let your child drive or return to activities.Watch for red flags and signs and symptoms of concussion.

DO NOT give your child any medications. There is evidence that some medications can worsen concussion symptoms and could increase potential risks associated with brain injuries. Do not give your child any medication unless directed by a doctor.

Concussion Response Tool

The Concussion Response Tool was developed to assist coaches and parents to recognize and respond to concussions. The first two pages outline how to respond to a concussion at the time of the incident. The third page provides important information for parents who are caring for their child at home after the incident.

The Concussion Response Tool can also serve as an important communication tool for sharing information from the scene of the incident.

Preparing for the doctor

Your doctor will have questions for you and your child. The doctor will want specific details about the incident and your child’s medical history. Complete the  Concussion Response Tool  and take it with you to the doctor. This will help the doctor to assess your child.

Questions to Ask Your Doctor is a helpful resource that provides a variety of questions you can discuss with your doctor.

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My child has a concussion. What is the recovery process?

Most adult concussion signs and symptoms last 7-10 days. Children tend to experience a more delayed recovery. Many children will take 2 to 4 weeks to heal though for some it could be months. Having had a previous concussion increases the chance a person will have a delayed recovery.

Symptoms should be decreasing over time. Take your child to the doctor if you are worried that your child is not improving or their symptoms are prolonged.

Concussion Recovery Process for Parents

The Rest Stage

The first and most important step in your child’s recovery from a concussion is rest. Your child will need both physical and cognitive rest after sustaining a concussion.

Physical rest means participation in daily life activities that do not result in an increased heart rate or breaking a sweat.

Cognitive rest means limiting activities that require concentration and learning.

The goal is to not trigger or worsen symptoms.

Once symptom-free for a 24 hour period your child can begin to add activities and focus on returning to school. Time within this stage varies with each concussion case.

As new activity levels are introduced, symptoms could return or new symptoms could appear. This means the brain needs more time to heal. If at any point symptoms return, stop the activity and rest until symptom-free.

Physical
Restrict Activities that may be tolerated
Exercise
Sports
Riding a bike
Running
Play wrestling
Daily activities that do not increase heart rate or break a sweat.
Cognitive
Restrict or Limit Activities that may be tolerated
Computers
Smartphones
Video games
School work
Watching TV
Playing music
No headphones
Loud music
Reading
Socializing
School attendance
Drawing
Playing with lego
Playing cars/trains
Baking** Low Level Social Interactions (try in short periods)

Social interactions that do not cause symptoms are important in preventing social isolation or depression and anxiety. Some suggestions of low level social interactions are short conversations on the phone with friends and family or a meal with grandparents.

Once symptom-free at rest it is important that your child has successfully returned to school full-time before they begin to return to play sports. Returning to play too early may result in more severe or potentially long term problems. A focus on return to learn first has been shown to lead to a quicker return to play.

Coping with your child’s emotions

It is normal for a child or adolescent to be anxious, angry and depressed after sustaining a concussion. Many children worry about school and social failure. Reassure your child that this is only a temporary situation. Talk with your child about these issues and offer encouragement and support.

Depression can be a part of the long term consequences of concussion. Your child may be feeling depressed due to a loss of place in school, on a team or social life. Depression in some children can be the result of physical changes in their brain associated with the injury itself.

If you think your child is depressed or suffering from anxiety talk to your doctor.

How does my child successfully return to school and play?
Return to Learn

After your child is free from symptoms for 24 hours they may begin a gradual return to school. One of the most common problems during recovery is returning to full activities too soon. It is important that children and adolescents follow a controlled gradual return to school.

The Return to Learn Protocol will help guide your child to return to school before they return to play sports. The goal of working through the return to learn stages is to increase cognitive activity gradually without triggering any symptoms (even very mild symptoms).

If symptoms worsen during any activity, STOP the activity. Once symptom-free return to a reduced activity level or reduce the time spent within the activity.

For example, if reading for 30 minutes produces a headache the child should stop reading until they are symptom-free. Once symptom-free the child can resume reading, but for a maximum of 20 minutes. After 20 minutes of reading, the child should take a break from activities requiring them to concentrate. If they remain symptom-free after the break, they can resume reading for another 20 minutes. This can be repeated several times in a day as tolerated.

The time it takes to successfully return to learn varies with each concussion case.

Inform your child’s school

Your child’s school may or may not have a concussion management plan. Inform the administration that your child has sustained a concussion. You may want to set up a meeting with the principal, your child’s teacher(s), resource teachers and counselors to discuss the best return to school plan for your child.

Once your child has successfully returned to a full day of school they may begin to focus on returning to sports.

For a child who works

A child who both works and goes to school should return to school before work. If your child works but does not go to school, they should focus on returning to cognitive aspects of work before physical activities. Use the return to school guidelines to help guide this process. Once they are successfully back to a normal cognitive level of activity they can use the return to play protocol to guide their return to physical activities.

How does my child successfully return to play sports?

Return to Play

It is important that your child has successfully returned to school full-time before they return to play sports. Returning to play too early may result in more severe or potentially long term problems. A focus on return to learn first has been shown to lead to a quicker return to play.

The Return to Play Communication Tool will help guide your child to return to play sports. The goal of working through the return to play stages is to increase physical activity gradually without triggering any symptoms (even very mild symptoms).

Your child must be symptom free for at least 24 hours at one stage before advancing to the next one. If at any time the symptoms RE-APPEAR, then they must go back to the previous stage until they are symptom-free again for 24 hours.

If a NEW symptom appears, your child should see a doctor to be cleared to continue on the return to play stages. The return to play stages typically takes 7 to 10 days for adults to complete and longer for children and adolescents.

Return to Play Communication Tool

The Return to Play Communication Tool will help guide your child’s recovery and communicate the child’s progress to coaches and physical education teachers. You may need to provide your child’s coaches and teachers with an explanation of the return to play stages and the purpose of this communication tool.

It is important to record the date and time of when your child is symptom-free so that they can be cleared to move onto the next stage.

Medical clearance is required before your child moves to full-contact practice (stage 5).

How can I help to prevent concussions?
Equipment

Helmets and mouth-guards are vital pieces of equipment that protect the player from serious skull and dental injuries, but they do not prevent the brain from moving around when there is impact to the head.

There is no equipment that can totally prevent concussions. Ensuring that your child has the required equipment for the sport, that it is in good condition and fits correctly, could decrease incidents that cause concussions.

Encourage fair play

A child’s behaviour and attitude about sports has a major impact on concussion causing incidents. Remember your child is watching you. You can encourage fair play by modeling respect and fair play in the presence of your child.

Children will often hide symptoms of concussion because they don’t want to disappoint their team or parents. An injured child needs to feel confident in reporting their symptoms. Creating a positive avenue for reporting concussion symptoms sooner can make the biggest difference in preventing more serious concussion outcomes and associated risks.

Learn more about concussions

Educating yourself is the first step in preventing concussions and reducing associated risks for your child. You can further educate yourself by taking the Concussion Awareness Course and checking out the Resources where you will find videos, expert talks and articles.

Teach your child

Teaching your child about concussions helps them understand how serious a concussion injury can be. It also gives them the tools to recognize and report if they do sustain a concussion. An informed child is more likely to comply with the recovery process. Use the resources in the Players section to help teach your child about concussions.

Red Flag Symptoms

If your child shows any of the following Red Flag Symptoms call 911 immediately.

 

  • Neck pain
  • Increased confusion or irritability
  • Repeated vomiting
  • Seizure or convulsion
  • Weakness in arms/legs
  • Tingling or burning in arms/legs
  • Deteriorating consciousness
  • Loss of consciousness
  • Severe or increasing headache
  • Unusual behaviour change
  • Double vision