New Child Concussion Treatment Recommendations

The New York Times reports that there is some controversy surrounding new recommendations on how to react when a young athlete is thought to have suffered a concussion. The new recommendations were developed and approved by a group at the 3rd International Conference on Concussion in Sport, sponsored by FIFA and held at their campus in Zurich in November of 2008. The British Journal of Sports Medicine published a supplement to their May 2009 issue devoted to concussion research (particularly that information shared at the aforementioned conference), though unfortunately the full text of the articles is only available to journal subscribers.

However, the abstracts are available for free, and as reported in the Times, the abstract of Purcell's "What are the most appropriate return-to-play guidelines for concussed child athletes?" states the the recommended practice is to wait at least one day before allowing children to return to play after they have suffered (or are suspected to have suffered) a concussion. Also identified as problematic in Purcell's abstract are the developmental influences on the psychometric assessment of child concussion, as well as the lack of child-specific assessment instruments. The Times suggests that Purcell's article also recommends that students avoid cognitive stress immediately following a concussion, including staying away from the classroom as well as technological stimulation.

Although there may be some merit to the potential for controversy surrounding these recommendations, specifically the concerns that players will not report concussion events to coaches / staff when they initially occur and therefore make it more likely for a severe second concussion to occur, I hope that these fears do not bear more weight for schools and athletic organizations as they develop policies for best practices surrounding children who suffer from concussions. We must develop child-specific instruments to assess cognitive changes following a suspected concussion, and we must err on the side of child safety and limit the athletic, scholastic, and other physical and cognitive demands on children who have suffered concussions - at least for one day, or until symptoms go away - so as to be sure to avoid dangerous back-to-back concussions. Given the mounting evidence of the short- and long-term damage done by concussions, it is imperative that we follow the advice of experts in protecting the brains of student athletes.