This winter season, Concussion starring Will Smith was an enlightening and influential film. Based on the true story of Dr. Bennet Omalu who studied repeated sports head injuries in professional football players, the movie brought into light some effects of brain trauma on the human brain.
Although the film focuses on brain trauma in adults, it serves as a reminder that children and parents should understand the importance of preventing such incidents in young athletes. According to the U.S. Centers for Disease Control and Prevention (CDC), the Emergency Department Visit rate of Traumatic Brain Injury (TBI) in 5-14 year-olds has increased from 498.8 to 888.7 per 100,000 visits between 2001 to 2010. This is over a 78% increase in ED visit rates, which brings up some important questions.
What is a concussion?
As defined by the CDC’s “Heads Up” flier for their campaign to prevent concussions,
“A concussion is a type of brain injury that changes the way the brain normally works. A concussion is caused by a bump, blow, or jolt to the head. Concussions can also occur from a blow to the body that causes the head and brain to move rapidly back and forth. Even what seems to be a mild bump to the head can be serious. Concussions can have a more serious effect on a young, developing brain and need to be addressed correctly”
What do you do you if you suspect brain trauma in a child?
Here are some symptoms of concussions from the CDC. If any of these are present, it is recommended to seek emergency care right away:
- One pupil (the black part in the middle of the eye) larger than the other
- Drowsiness or cannot be awakened
- A headache that gets worse and does not go away
- Weakness, numbness, or decreased coordination
- Repeated vomiting or nausea
- Slurred speech
- Convulsions or seizures
- Difficulty recognizing people or places
- Increasing confusion, restlessness, or agitation
- Unusual behavior
- Loss of consciousness (even a brief loss of consciousness should be taken seriously)
These signs also may indicate a concussion and if parents notice one or more of them, they should seek medical help. Some symptoms may present a few days after the injury and can include:
- Appears dazed or stunned
- Is confused about events
- Answers questions slowly
- Repeats questions
- Can’t recall events prior to the hit, bump, or fall
- Can’t recall events after the hit, bump, or fall
- Loses consciousness (even briefly)
- Shows behavior or personality changes
- Forgets class schedule or assignments
Changes in energy, attention, behavior, memory, or sleep may also result from a concussion (CDC).
What does this have to do with speech and language therapy?
As the symptoms above indicate, so many aspects of the effects of TBI and concussions in children affect communication. One of the many roles of Speech-Language Pathologists in schools, clinics, and other settings is to advocate and prevent any disturbances to communication disorders.
Communication may be affected by repeated brain injuries in many ways, depending on the injury. Two types of injuries resulting from concussions are post-concussive syndrome and second impact syndrome. Post-concussive syndrome includes symptoms such as the ones listed above, and may begin a few days after the injury; second impact syndrome results in brain swelling and occurs after more trauma to the brain before the first concussion has healed (Mayo Clinic). When these injuries impact personality, memory, concentration, and social skills, they can affect a child’s ability to communicate effectively.
How can we prevent brain trauma in children?
We encourage children to be active and social members of society. Engaging in team sports, games, races, and other athletic play is so beneficial for kids, but there are also risks involved. Children should be encouraged to play safely and use adequate protection while engaging in physical activity. The CDC states that helmets are NOT concussion-proof even though they are recommended for protective purposes, and many concussions occur even while wearing helmets. Additionally, while some trauma can be prevented through the use of helmets, it’s important to remember that not all sports teams practice and compete while wearing helmets, such as soccer and rugby.
In the 2011 American Speech-Language and Hearing Association convention, Nancy Manasse-Cohick proposed the “three R’s” of concussion management:
Using our knowledge about what a concussion is and what signs to look for, recognizing the occurrence of such an injury is the first step!
If a concussion is suspected, tell someone immediately! Seeing a doctor is very important in determining the severity of the injury.
Children should NEVER return to game play the day of a suspected concussion; they should wait until they have been cleared by a medical professional (CDC). Returning to game play before healing can cause second impact syndrome, described above.
Finally, there are amazing educational and prevention resources available regarding concussions online for parents, teachers, and anyone else who needs to know! We encourage you to learn more so our kids can socialize and play safely.
Concussion. (n.d.). Retrieved January 21, 2016, from http://www.mayoclinic.org/diseases-conditions/concussion/basics/complications/con-20019272
Heads Up Schools: A Fact Sheet for Parents. (n.d.). Retrieved January 21, 2016, from http://www.cdc.gov/headsup/pdfs/schools/tbi_factsheets_parents-508-a.pdf
Manasse-Cohick, N. (n.d.). The Role of the Speech Language Pathologist in Concussion Education. Lecture presented at ASHA 2011, San Diego, CA.
Rates of TBI-related Emergency Department Visits by Age Group — United States, 2001–2010. (2014). Retrieved January 21, 2016, from http://www.cdc.gov/traumaticbraininjury/data/rates_ed_byage.html