Kids With Concussions Need Specialized Assessment and Care

Learn why cutting-edge care and research specifically for children matters.

The 2020 National Health Interview Survey reported that 6.8% of children experience symptoms of a concussion or brain injury in their lifetime. However, only 3.9% had received a diagnosis or treatment of a concussion or brain injury from a health care provider.

The Concussion Center at Nationwide Children’s exists to fill that gap. As co-director of the Complex Concussion Clinic at Nationwide Children’s, my team and I are concerned about the accurate diagnosis and treatment of children with concussions. Kids with concussions have different needs than adults. A growing body of evidence supports heightened concerns about the consequences of mild traumatic brain injury or concussion in children.[1]

Kids require specialized diagnosis and care from physicians trained in pediatric concussions.  Why? Because school, sports, mental health, and family routines can be affected by a concussion. Management of these lifestyle aspects is critical to a successful recovery. There is no one-size-fits-all treatment for pediatric concussion. Each child responds to treatment differently.

We believe that the following four pillars are essential to supporting concussion recovery.

• Return to School – Concussions can affect how children think and learn. They often need a reasonable approach to learning as they recover. Our providers work with each child’s school to support their academic needs.
• Safe Return to Play – Kids who participate in sports want to return to their activities as soon as possible. Our athletic trainers and physicians collaborate with school coaches and athletic trainers to support this process safely.
• Focus on Mental Health – Mental health is equally important as physical health. Mental health screens are essential during all stages of concussion care. Our physicians work with psychology and neuropsychology providers to respond to children’s unique mental health needs through pediatric-specific cognitive assessments and treatment.
• Get Back to a Routine – Kids need routine and structure, as well as medical treatment, to heal. We integrate each patient’s family into their treatment plan for the best results. Our physicians also provide the best medications for headaches and other symptoms of a concussion to allow kids to get back to their routines as soon as possible.

There is still much we need to learn about how concussion affects children. The Concussion Center at Nationwide Children’s is leading several research studies aimed at improving outcomes for children. For example, we are studying the effect of cognitive behavior therapy tailored to concussion recovery in kids with prolonged symptoms. There is also a team using state-of-the-art simulation to study automobile driving performance in teenagers with concussions. We are also studying the specific concussion symptoms and recovery in children younger than six years old. Among other research projects, a team is identifying how the decision to retire from contact sports after a concussion affects kids’ mental and physical health. Each study will provide critical insights into how kids experience concussions and how we can best treat them for successful recovery.

The Concussion Center is organized into three unique clinics. This structure allows our teams to provide personalized treatment that meets the needs of each child.

• Sports Medicine Concussion Clinic: Pediatric sports medicine specialists treat kids injured during sports activities or those trying to return to a sport or other performance activity. The focus is on getting the child back to school and safely to play.
• Physical Medicine and Rehabilitation Concussion Clinic: For kids who sustain non-sports-related injuries or are in the hospital, we diagnose and treat each child’s individual medical and mental health needs
• Complex Concussion Clinic: About 20 to 25% of kids with concussions experience prolonged symptoms for more than one month. When this happens, our unique clinic offers a team of specialists, including neurologists, neuropsychologists, physical therapists, and athletic trainers, working together to assess each patient and develop a comprehensive care plan to help kids and adolescents return to their activities. We published a study on this promising multidisciplinary treatment approach in Developmental Neurorehabilitation.[2]

Because the clinics are under the umbrella of the Concussion Center, only one referral per patient is needed. This is not always the case when doctors refer their patients to other hospitals and clinics.

Nationwide Children’s-focused care for concussion, like that offered at the Concussion Center at Nationwide Children’s, is the best approach for children and adolescents. By providing expert, evidence-based care, we are able to make sure these youth receive appropriate diagnoses and treatments following the latest guidelines to ensure the best possible outcomes.

References:

[1] Lumba-Brown A, Yeates KO, Sarmiento K, et al. Diagnosis and Management of Mild Traumatic Brain Injury in Children: A Systematic Review [published correction appears in JAMA Pediatr. 2018 Nov 1;172(11):1104]. JAMA Pediatr. 2018;172(11):e182847. doi:10.1001/jamapediatrics.2018.2847

[2] O’Neill JA, Rose SC, Davidson AM, Shiplett KM, Castillo A, McNally KA. Predictors of Treatment Response to Multidisciplinary Care for Persistent Symptoms after Pediatric Concussion. Dev Neurorehabil. 2022;25(1):38-44. doi:10.1080/17518423.2021.1917719

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