How to Handle Your Child's Concussion
Recognizing the signs of a concussion and responding correctly can make all the difference in how quickly your child recovers. Learn more about the causes and symptoms of a concussion. Then follow this treatment calendar.
If your child sustains anything beyond a light bump on the head, the American Academy of Pediatrics recommends putting in a call to your pediatrician. Early concussion symptoms usually include headache, nausea, light or noise sensitivity, confusion, dizziness, difficulty recalling events, and fatigue. After you've consulted with the doctor, the next prescription is rather simple. "The initial treatment for a concussion is to rest at home," says Matthew Grady, M.D., a pediatric sports medicine specialist at the Children's Hospital of Philadelphia. But if you return home and notice any of the following more serious symptoms developing, go to the E.R. immediately: vomiting more than once, worsening headache, clumsiness, disorientation, irritability, slurred speech, blood or fluid from the ears or nose, changes in breathing pattern, dilated pupils or pupils of unequal size, a seizure, convulsions or a loss of consciousness that lasts more than a minute.
Days 2 to 6
Keep your child home from school and follow up with your doctor two to three days after the injury to report your child's condition. You should see his symptoms gradually improving, and your doctor will help decide when it is appropriate to return to school. During this first week, kids need and should be encouraged to get extra sleep. While your child is awake, it's important to choose activities that won't make the symptoms worse -- that is, nothing too brainy or physical (think baking cookies, going for short walks, or playing easy card or board games). Watching TV is fine, too, because it doesn't demand much from the brain.
Activities that involve a lot of eye tracking, like video games and using a computer, sustained reading (especially smaller print), or visiting a crowded, loud, brightly lit environment such as a shopping mall, should be avoided, as should aerobic activity. "Kids with mild concussions may have minimal symptoms with most activities and may tolerate some reading, while others with severe concussions may experience a lot of symptoms with even simple tasks," Dr. Grady explains.
Weekly follow-up visits with the doctor will begin now, along with a discussion about returning to school. "A high school student with an uncomplicated concussion may take one to two weeks to heal, but for a younger child it'll be more like two to three weeks," Dr. Grady says. Each concussion is different, so there are no absolutes when it comes to management. It's also important to continue relative cognitive rest, so be sure your child refrains from texting, video games, and excessive reading and studying if these are making symptoms worse. Diverting the brain's energy toward these activities means there's less energy to devote to the healing process.
Your child may be starting to feel frustrated, sad, and even angry because she can't participate in social activities, school, or sports. Be as supportive and understanding as you can, reminding her that her injury is temporary and how important it is to give her brain extra time to heal.
Days 8 to 13
Before giving the okay to return to the classroom, the doctor will likely recommend that your child try to do some schoolwork at home. If this can be accomplished over the next few days, without increasing or worsening symptoms, then your child is probably ready to head back to class.
If your child is ready to return to the classroom, school professionals, including his teacher and the school nurse, will monitor his reentry and should be on the lookout for the following: difficulty paying attention, increased problems with learning new information, difficulty organizing tasks, inappropriate or impulsive behavior in class, inability to cope with stress, fatigue, and sensitivity to the school environment (light, noise). Participating in gym, recess, or rejoining a sports team should be allowed only with written clearance from your child's doctor.
All symptoms should be gone at this point, though if any persist beyond a month or are severe, your pediatrician will likely recommend a consultation with a specialist in concussion management. Special education plans can also be developed that outline academic adjustments, such as providing your child extended time for homework assignments or test taking.
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