For Parents - Concussion Program | Children's National

When a concussion is suspected or first diagnosed, parents often have questions about the injury and how to help their child. These questions can arise the first day of the injury or may occur several days to weeks after the injury. There may be questions about returning to school, social, leisure or recreational activities.

Concussion Facts

All concussions are serious, but the vast majority get better without long-term consequences.
Most concussions occur without loss of consciousness and can include a wide variety of cognitive, physical, emotional, and sleep-related symptoms.
Recognition and proper response to concussions when they first occur can help prevent further injury and prolonged recovery.
When in doubt, sit them out from intense activities and contact sports.
Proper concussion management should include individualized recommendations to address activities across the home, school and recreation environments.

What Children’s National Hospital Offers

The Children’s National SCORE Concussion program is staffed by neuropsychologists and neuropsychology post-doctoral fellows who can assess and treat children, teens and college student-athletes, ages 4-22, who have sustained a concussion. An important part of treatment is educating the student and parents about concussions, the risks of re-injury, and ways to ensure recovery.

Our staff will conduct a complete evaluation that measure attention, memory, speed and balance. These help us understand the child or teen’s cognitive functioning. We will work with the child or teen and parents to develop a treatment plan to support full recovery. That plan will include a timetable for returning gradually to school, sports and other life activities.

Parents will receive a copy of the ACE Care Plan, which summarizes this information. This plan also will help parents communicate the evaluation results and treatment recommendations to school personnel, the referring physician or other medical professionals. Return visits may be scheduled to adjust treatment until the child has fully recovered and symptoms are no longer present.

Frequently Asked Questions for Parents

After a concussion, should my child see their pediatrician for an examination?

Can I give my child medicine for their headaches? What about taking their other regular medications?

After a concussion is diagnosed, talk to your physician about the use of medication for headache pain or other symptoms. Relieving headache pain is certainly appropriate but does not replace the need for cognitive and physical rest if symptoms are at all present. Be aware that symptom improvement with medication does not mean that the brain has recovered. Symptoms must improve while not on medication before returning to typical activities, particularly contact sports or high risk activities. Decisions about continuing to use other medications should be done in consultation with your physician.

Do I need to keep my child awake all night or wake him or her up regularly?

No, sleeping does not make brain injuries worse. In fact, sleep is actually very important for recovery. The brain's energy after a concussion is reduced significantly and there may be a powerful urge to sleep. The general recommendation is to let your child sleep after their injury, but occasionally check on them (gently push or nudge them) to be sure that they respond to you in some way. You do not need to wake them up fully.

The concern is that if your child is sleeping, you cannot see possible signs of a more severe brain injury, related to a bleed in the brain or swelling. These signs are listed in the Danger Signs:

Headaches that worsen
Very drowsy, can't be awakened
Can't recognize people or places
Seizures
Repeated vomiting
Increasing confusion
Neck pain
Slurred speech
Weakness/numbness in arms/legs
Unusual behavior change
Significant irritability
Less responsive than usual

If the child is not responsive to gentle prodding, you should seek emergency medical care.

My doctor (coach, athletic trainer, etc.) initially said that my child could return in two weeks. Is this the right amount of time after a concussion?

It is very difficult (if not impossible) to predict the length of recovery of a concussion at the time of the injury. No specific time period should be given without regard to the child's unique symptom recovery. The decision to return to a sport is an individualized medical decision, and based on the child's actual symptom and neurocognitive recovery. Once the symptoms are fully gone, the child can begin a supervised gradual return to play program.

My child has now had multiple concussions. How concerned should I be, and should my child continue to play contact sports?

You should be concerned, but you should also consult a concussion specialist to understand if there is likely to be any possible lasting effects for your child. The effects of multiple concussions vary widely for different individuals. Some may still recover quickly, while others do not. There are no steadfast rules as to how many concussions are too many, but if your child has had multiple concussions, you should seek the advice of an expert.

How do I explain my child's injury to their school?

It is important to explain your child's injury and the types of symptoms to all key school personnel. A child who returns to school with symptoms (e.g., headache, tiredness, difficulty concentrating) is not ready to participate fully in all school activities, and should not be expected to take exams or quizzes. They may need to put their head down during class or be excused to rest in the nurse's office. The CDC School Toolkit, available on the web for free, is a great resource to help schools understand this injury.

What are the long-term effects of a concussion?

What is neuropsychological testing and what is it used for?

Neuropsychological testing is one of the tools used in a concussion evaluation. The testing involves assessing the child's attention, memory, speed of thinking, and balance as well as looking for symptoms in response to increased cognitive exertion. These functions and symptoms are sensitive to the effects of a concussion. Cognitive performance that is not normal for that child can be one indicator that the brain is not working properly. However, there are many reasons why a child's neuropsychological test performance can be abnormal and, if possible, it is important that a skilled neuropsychologist be involved in interpreting the results of these test findings.

Can my child go out with their friends? Can they have sleepovers?

Can my child watch television, play video games, text, etc.?

My doctor told my child to rest. What exactly does "rest" mean?

Rest means reduced physical and cognitive activity. The goal is to minimize brain activity to promote healing, while balancing activities that are safe and well-tolerated (do not result in significant increase in symptoms). Resting can be lying in a quiet room, reading a magazine or watching mindless television. Resting should not include spending long periods of time in activities such as walking around the mall for hours, studying or listening to loud music. Resting does not include prolonged screen usage. Pushing through significant symptoms to engage in activities may delay recovery. The goal is to balance brief rest with modified cognitive and physical activity, with gradual increase in activity as symptoms allow.