Concussion and Mild Traumatic Brain Injury in Children

What are the signs and symptoms of a concussion?

Signs and symptoms of a concussion can vary greatly. Most young people will completely recover from a concussion within a few weeks of the injury, but some can take longer to recover and require specialty concussion care.

Common signs and symptoms of a concussion in children include:

Physical symptoms

• Headaches
• Sick to stomach
• Dizziness or balance problems
• Low energy or feeling run down
• Trouble with vision
• Bothered by light or noise
• Sleeping problems

Cognitive (thinking) symptoms

• Slowed thinking
• Trouble paying attention
• Difficulty remembering things
• Acting "foggy"
• Confusion
• Changes in school performance

Behavioral or emotional symptoms

• Irritability or grouchiness
• Easily upset or frustrated
• Nervousness
• Sadness
• Acting without thinking
• Any other personality changes

Consider seeing a concussion specialist if: 

• Significant symptoms or changes in behavior last more than two weeks after a head injury 
• Any cognitive concerns or problems in school are especially severe 
• Your child has difficulty returning to physical activity or sports 
• Your child has had multiple concussions and they’re considering returning to sports or other activities 
• Your child has been diagnosed with a more serious brain injury (for example: an injury with bleeding or bruising found on a CT or MRI scan of the brain)

How do the experts at Children's Hospital Colorado evaluate a concussion? 

In the Concussion Program at Children's Colorado, evaluating a child with a suspected concussion may include: 

• Medical and neurological exams for post-concussion problems 
• Neuropsychological evaluations to assess thinking processes like memory or attention 
• Psychological evaluation to identify any emotional factors that may interfere with recovery 
• Physical therapy and rehabilitation care for symptoms such as neck pain and balance issues or dizziness 
• Helping determine when a young athlete can safely return to sports 
• Imaging to rule out medical emergencies or further brain injuries that may affect treatment 
• Coordination of school plans to support educational needs

If your child is diagnosed with a concussion, we'll help develop a treatment plan to address school issues, support recovery and manage changes in behavior. Experts from our Concussion Program also provide referrals to specialists in education, physical therapy, behavioral health, neurology and other medical areas when needed.

How do we treat a concussion?

Our Concussion Program evaluates and treats children and teenagers who’ve had concussions and other types of mild traumatic brain injuries. Treatment for a concussion focuses on adjusting your child’s day-to-day life so they can heal. We will provide your family with an individualized treatment plan after a thorough diagnosis that rules our more serious issues.

Although most children and teens recover within a few days to a few weeks, our experts will determine if your child needs further rehabilitation, physical therapy or other treatments.

How can parents help treat a concussion?

A concussion can be scary and stressful for both you and your child. It's important to remember that most symptoms will last for only a short time. The following suggestions should be helpful as your child is healing from the concussion: 

• Keep your child safe. It’s important that your child doesn’t hit their head again while healing. Your child will need to take a break from sports and other activities that might cause another head injury. A healthcare provider should make the decision about when it’s safe for your child to return to activities, as well as develop a specific plan to return your child to sports gradually. 
• Have your child rest. Doing too much too soon after a concussion can worsen symptoms. In the first one to two days after injury, our experts recommend relative rest (not strict rest) and more down time than usual to rest and relax.
• Gradually reintroduce light physical activity. After an initial period of rest (24 to 48 hours), introducing light and progressive activity that doesn’t make your child feel worse is helpful. This activity can consist of something like a brisk walk, but it shouldn’t bring on any new symptoms or make their symptoms worse. Although regular physical activity is helpful during concussion recovery, it’s important that your child not return to strenuous exercise, including sports or other high-risk physical activity, without clearance from their healthcare provider.
• Make sure your child gets enough sleep and eats properly. Make sure your child gets plenty of sleep at night. Short daytime naps, if needed, are reasonable in the first few days after a concussion. Also, make sure your child eats healthy foods and drinks plenty of water.
• Allow extra time to finish things. Some children may be a little slower in how they do things after a concussion. Allow more time than usual to finish tasks.
• Give more chances to learn. Remember that things might be harder for a few days or weeks after the injury. When learning, make sure your child is paying attention. They might also need to hear or see information more times than usual. Make sure you tell school staff about the injury so they can watch for problems and provide extra help if needed.
• Allow more breaks. Paying attention during hard or boring tasks might be more difficult for a few days or weeks after the injury. Have your child take breaks when doing homework and other similar tasks.
• Be patient. Your child might seem cranky, more easily upset or more tired and forgetful. Be patient and understanding when this happens. If the behavior continues, talk with a healthcare provider.
• Partner with a professional. Healthcare professionals should always be involved in a young person's care soon after a concussion. You should also follow up with your child's primary care provider or a concussion specialist if your child's symptoms last for more than two weeks.

Why choose Children's Colorado's Concussion Program?

At Children's Colorado, we see thousands of children and teens each year who have suffered a concussion or other types of head injuries. Our Concussion Program includes a comprehensive range of services from medical consultation and appointments for concussions, to helping students return to school and deciding when athletes can return to play.

We are also national leaders in concussion research. As experts in the field, we are actively involved in several projects aimed at advancing our understanding of how young athletes recover from a concussion and the best ways they can fully heal after an injury.

Concussion Comeback Plan for teachers and parents

Recognizing the unique challenges faced by students recovering from a concussion, our experts created the Concussion Comeback Plan  to help parents and teachers guide students back into school. This plan will help you understand concussions, assign a comeback coordinator, support and monitor the student and identify signs that a student may need to consult a healthcare provider.

Concussions and helmet safety

Helmets are essential to protect children from injury and concussion. The following guidelines keep kids safe:

• You should always replace bicycle helmets involved in a crash. Even if there is no visible damage, the helmet may not protect your child as well in the next crash. 
• Helmets used for contact sports such as football, hockey and lacrosse should have a National Operating Committee on Standards for Athletic Equipment (NOCSAE) stamp of approval on them. The stamp is usually on the back or side of the helmet. 
• Do not purchase "used" helmets because the history and care of the helmet are unknown. 
• Helmets should only be used for the sport for which they are designed. For example, a football helmet should only be used for football, not for other activities.
• Children are much more likely to wear helmets if their parents or guardians wear helmets.