How To Better Identify Concussion in Children and Teens

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Plus 6 Tips for Getting an Accurate Baseline Measurement

According to the CDC, 1.6 - 3.8 million sports- and recreation-related traumatic brain injuries, including concussions, occur each year. Children and teens are more likely to get a concussion than adults are – in fact, children aged 5 to 18 years account for an estimated 65% of emergency department visits for traumatic brain injuries. Unfortunately, children and teens with traumatic brain injuries also take longer to recover, have an increased risk for future brain injuries, and have increased risk of developing depression and dementia.   The CDC states that measures be taken targeting this age group to improve diagnosis and management of mild brain injury, including concussions.

Because you can't see concussions, they are difficult to detect. Many children and athletes don't report their symptoms and are never evaluated for their injuries.  In fact, the CDC estimates only 5.5 - 13% of traumatic brain injuries actually go to the emergency department.

One way schools are monitoring their athletes is conducting baseline tests (also known as neurocognitive tests) to assess brain function during the preseason. These baseline tests assess learning, memory, concentration, and problem solving skills. Then, if an athlete has a suspected brain injury during the season, the athlete would take the test again and the results would be measured against their preseason test to help identify the severeness of the injury.

Steps for Baseline Concussion Testing:

1. Schedule enough time.  Baseline testing typically takes a minimum of 25 minutes per person.

2. Determine how you are going to administer the baseline tests. The preferred method is to test individually or in small groups, but some schools will perform group testing in the school computer lab with proctored supervision or allow a parent to test the athlete at home with an online login to the baseline software.

3. Determine who will administer the test.  The testing proctor should be directed or trained by a clinician (such as a School Nurse, Athletic Trainer, Physician, Neuropsychologist, etc.).

6 Tips When Conducting the Baseline Test:

1. Ask about the athletes vision of the computer screen.  Do they wear glasses... are they wearing them?

2. Is the athlete comfortable during testing - seating, arm positions, recent restroom visit? Check for any hand or arm injuries or seating challenges that might impede testing.

3. Make sure the testing environment is free from distraction - possibly use noise canceling headphones or ear plugs and have the athletes use the restroom and get a drink prior to beginning the assessment.

4. Testing should NOT be done if the athlete is fatigued or distressed, or if they have been under the influence of brain altering substances within the last 24 hours.

5. Turn off all cell phones, PDA's, etc. and closely proctor group testing to minimize horseplay. Emphasize the importance of reading the instructions prior to proceeding.

6. Remind the athletes if they DON'T give the testing their best effort (the test has embedded markers of VALID effort) they may have to repeat the testing.

If you are interested in conducting baseline tests on your student population, School Health offers an affordable concussion detection software for schools.  Learn more >>

We also carry a variety of products that help educate school communities about the signs and symptoms of concussion.  View all concussion products >>