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Concussions in Elementary School: What you need to know

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boy with soccer ball.concussionImagine you’re seated at work when you receive a call from the school nurse who tells you your son hit his head during recess. Thankfully, he didn’t lose consciousness, so no concussion, right?

Not necessarily.

Elementary-aged students do not lose consciousness as easily as teens or adults do. They also may not yet have the language skills necessary to convey the pain or symptoms they are experiencing. They might simply say they don’t feel “good.” With children participating in contact sports at younger ages it is crucial for parents, coaches, teachers and school nurses to be aware of the signs of a concussion and diligent about any changes in behavior that could signal the need for treatment.

Changes in behavior in children with concussion may include:

  • Appearing dazed or stunned
  • Being unsure of game, score or opponent
  • Moving clumsily
  • Showing behavior or personality changes
  • Having difficulty organizing tasks or shifting between tasks
  • Displaying inappropriate or impulsive behavior
  • Exhibiting greater irritability
  • Behaving more emotional than usual
  • Experiencing fatigue
  • Having difficulty handling a stimulating school environment (lights, noise, etc.)
  • Experiencing other physical symptoms (headache, nausea, dizziness)

If you observe any of the above symptoms you should contact a healthcare professional immediately. They can help you set up a plan for treatment and recovery. It is important to work with your healthcare provider as concussions affect people differently. Younger children can experience symptoms lasting anywhere from a few days up to a week. While children often appear to bounce back from everyday injuries, they actually take longer to recover from concussions than adults.

The best treatment for concussions – regardless of age—is rest, both physically as well as mentally, as this helps the brain heal. Restricting strenuous physical activity and getting plenty of sleep are very important for a steady recovery, but rest also involves cognitive rest, which means limiting mental tasks that require concentration or focused thinking. This includes no or limited screen time (phone, TV, computer) as the screen can worsen symptoms. Lighter mental activities, such as listening to audio books or drawing, are usually acceptable. However, it is important to continue monitoring for increased pain or behavioral changes. School work and reading are to be reintroduced gradually, stopping if symptoms reappear. Regardless of a child’s seeming recovery, students need to be evaluated and cleared by a doctor before returning to school or sports.

Because children who play sports are at greater risk for concussion, Harvard Vanguard offers ImPACT testing, a computerized concussion evaluation tool. We perform baseline testing – done before a child has a concussion – for kids 10-19, which can then be used as a point of comparison for tracking recovery if a child experiences a head injury in the future. ImPACT baseline testing is performed at 6 of our pediatric locations:

Braintree – (781) 849-2300

Burlington – (781) 221-2800

Concord – (978) 287-9400

Kenmore – (617) 421-8888

Quincy – (617) 774-0660

Watertown – (617) 972-5570

Sports, recreational activities and being generally active are all great for kids. As long as parents or guardians, coaches, and other supervising adults are diligent about monitoring activity, healthy and safe fun can be had by all.


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