Concussion is an injury to the brain caused by either a blow to the head or body. A child’s developing brain is more at risk than an adult’s, so parents and caregivers may want to know the signs of concussion in children.

A survey published in 2017, looking at more than 13,000 adolescents in the United States, found that almost one-fifth reported having had a concussion at least once.

In this article, we will look at the warning signs and how to spot concussion in a child, plus what to do if you think a child has concussion.

Concussion is a type of brain injury that happens when a blow to the head or body causes the brain to move in its surrounding fluid.

The brain can twist or knock against the skull, temporarily affecting how a child thinks and acts.

Concussion is a mild form of traumatic brain injury or TBI.

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A child with concussion may have a headache and feel dizzy.

It may not be a hard hit that causes a concussion. In most cases, the child does not lose consciousness.

Signs of concussion may not be obvious. They can be physical such as a headache, but may also show in the way the child acts or feels.

People should look for the following warning signs of concussion in children:

  • headache
  • sleepiness
  • feeling like they are in a fog
  • feeling sick or vomiting
  • sensitivity to noise or light
  • seeming irritable
  • sleeping more or less than usual
  • feeling depressed or sad
  • feeling dizzy or having problems with balance
  • unable to think properly or concentrate

The signs of concussion do not necessarily develop right after impact. Some can take hours or even days to appear. Parents and caregivers must, therefore, keep a watchful eye on the child for some time after they hit their head.

The child or teen may not always be aware of their symptoms, and so adults need to watch for signs that the child may not report.

When checking for signs of concussion, people can ask questions, such as, does the child:

  • seem confused or dazed
  • struggle to answer questions
  • have no memory of what happened before or after the knock
  • move clumsily
  • remember the score or the game if injured during sport

Concussion in babies and toddlers

Babies and very young children may not be able to tell you what is wrong. As well as all of the signs above, people should also watch for a young child who is:

  • unable or unwilling to nurse or eat
  • crying and will not be comforted
  • losing interest in toys
  • losing new skills, such as toilet training

If the child is playing in a sport and someone or something hits their head, immediately stop them from playing any more and observe them. Many states in the U.S. have laws to make sure this happens, and all states have some concussion law.

If a person is unsure whether a child has got a concussion, the CDC recommend they should avoid returning to the game, including the slogan “When in doubt, sit them out” in their advice.

People must call a doctor if the child reports or shows any of the above symptoms or signs. These can happen at the time of the injury or several hours or days later.

In rare cases, a head injury can cause a hematoma in a child’s brain.

A hematoma is a collection of blood that forms in the brain and squeezes it against the skull. Doctors view a hematoma as a medical emergency.

People should either go to the emergency room or call an ambulance if a child has:

  • lost consciousness when hit
  • loss of memory for more than 24 hours
  • seizures, which could mean shaking or twitching
  • one pupil larger than the other
  • slurred speech
  • been unable to wake up
  • vomited repeatedly
  • symptoms that suddenly get worse

The primary treatment for concussion is rest. Rest helps the brain to heal.

The American Academy of Neurology, the American Academy of Pediatrics and the Child Neurology Foundation, as well as other experts, all recommend rest for children who have had a concussion.

What can you do at home?

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A child with concussion may sleep more than usual.

What people do at home to help a child recover from concussion is vital. Steps to take include:

  • make sure the child has physical rest and avoids sports or physical activity.
  • allow the child to rest mentally, too. They should not do anything that needs a lot of concentration, such as school work. Limit their screen time, such as video games and television.

Many children experience disturbed sleep after a concussion. They may sleep more than usual or find it hard to fall asleep or to sleep through the night. Caregivers can help by:

  • removing distractions from the bedroom
  • encouraging regular sleep routines, with no sleepovers or late nights

Headaches are the most common problem after a concussion. Simple analgesics can help, but people should check with their doctor.

How can a child’s school help?

The child’s school can help by:

  • providing rest breaks during or between classes
  • allowing a shorter school day
  • giving more time for homework and assignments
  • postponing tests
  • providing a quiet area if a child is sensitive to noise

After a few days of rest, the child can gradually return to their usual activities. Typically, they should not return to sports or vigorous physical activity until they have no symptoms at rest.

According to the CDC, most children will feel better within a couple of weeks. But for some children, symptoms can last for months or even longer.

A 2014 study found that nearly a quarter of children still complained of a headache one month after injury. About a fifth suffered from tiredness, and almost 20 percent said that they still took longer to think than they did before their injury.

People should talk to their doctor if the child’s symptoms get worse or do not go away. If a child is involved in sports, their doctor should be consulted to help develop a plan for safe return to play.

Some children may get post-concussive syndrome, causing their symptoms to linger. This is especially likely in children who have had more than one concussion.

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Playing football may put a child at an increased risk of concussion.

Any child or adult can have a concussion, though some groups are more likely to experience concussion than others, and for various reasons.

According to the Centers for Disease Control and Prevention (CDC), falls are the most likely cause of TBI diagnosed in the emergency room in infants aged 4 years and under.

Children aged 5–14 years old are prone to TBI from both falling and being struck by something or against something.

Young athletes seem to face an exceptionally high risk of concussion, especially those playing certain sports, including women’s soccer, football, basketball, and ice hockey.

Many states have concussion laws preventing people from returning to sports until doctors have given them medical clearance.

Children are at greater risk of receiving another injury to the brain during the period after a concussion.

The brain is particularly vulnerable during childhood and adolescence. A second concussion during this period is much more dangerous than the first. Chemical changes in the brain make it more sensitive to stress or another injury while it is recovering.

Most children will recover fully from a concussion. But for some, the effects can be serious and long-lasting.

The risk of severe complications is why people should always take a concussion in a child or teenager seriously, and the more adults who are aware of the signs, the better.