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Kids and Concussions: A Parent Primer on Initial Assessment

You're at your 10-year-old's soccer game and he's just collided with a member of the opposing team while fighting for a ball in the air. Unfortunately, the two hit heads and both leave the field crying, but clearly conscious. It's a youth game on an elementary-school field, so barring the presence of parent who happens to be a doctor, there's no one around to evaluate either child for a possible concussion. What to do? In many cases, both children will return to the game a few minutes later. Big mistake.

Concussions are serious whenever they occur, but unlike professional sports, when children suffer a possible concussion, there's often no one around to evaluate it properly. Here's what you can do to help identify some of the often-subtle signs of a concussion and make the informed decision to get further evaluation from a health care professional.

Clear Indicators

First, let's start with the most severe case: If a child experiences any of the following symptoms, particularly immediately after a collision or fall in which they struck their head, they need to go to the ER immediately for evaluation, according to KidsHealth.org:

  • Loss of consciousness
  • Severe headache / headache that worsens
  • Blurred vision
  • Difficulty walking
  • Confusion / not making sense
  • Slurred speech
  • Unresponsiveness (unable to be awakened)

Of course, many children may not display any of those symptoms following a head impact, but still be at risk for concussion, so it's important to evaluate the child with some a simple battery of initial tests that, if nothing else, will alert you to the fact that the child should a) be removed from the game; and b) seek medical attention. Here are a few of the ways you can get a sense of what may be going on. These and other variables are all part of the Sport Concussion Assessment Tool, which is used by health care professionals to help assess concussion symptoms:

Ask Questions

  • What month is it?
  • What is the date today?
  • What is the day of the week?
  • What year is it?
  • What time is it right now? (within one hour)

You can also ask the child questions specific to the event in which they are participating, such as:

  • At what venue (field, tournament, city, etc.) are we at today?
  • Which half is it now?
  • Who scored last in this game?
  • What team did you play last week / game? Did your team win the last game?

Give Them a List

Say a short list of words (example: apple, bubble, elbow, carpet, saddle) to the child and then have them recite the list back to you in any order. Repeat several times and assess how accurately they are able to recall all five words. You can do the same thing with a short list of numbers; or by having them recite the months of the year in reverse order.

Assess Behavior

The most important variable when it comes to determining whether your child should continue to play, be removed from play and/or be seen by a medical provider in the absence of clear symptoms (loss of consciousness, severe headache, slurred speech, etc.) may be how the child is acting compared to before the contact occurred. You know your child. If they're acting "out of sorts," err on the side of caution.

Keep in mind that the above should not be relied upon in lieu of proper evaluation by a health care provider, but if you suspect a concussion has occurred, these symptoms / signs and tests are an important first option to help determine the next step you should take. Talk to your doctor for additional information about concussions and how you can help keep your child safe on and off the field.