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Navigating Recovery After a Concussion

Erin Riley

The Concussion Centre of Holland Bloorview Kids Rehabilitation Hospital and GTHL have been teamed up since 2015, with the hopes of increasing awareness and knowledge of concussions.

When children and youth are diagnosed with concussions, the unexpected nature of these injuries often takes families through an equally unexpected ride.

Families can face a wide variety of changes – from challenging behaviours and emotions, to being absent from school or coordinating their respective schedules to ensure appointments are attended. The ways in which each concussion is experienced is different for each child, each youth and each family. Any time a concussion is experienced, knowing where to turn for recovery and support can help the family navigate the uncertain terrain.

What should I do if I think my child has a concussion?

There are two steps, both are critically important.

The first step for a child or youth that has suffered a suspected concussion is to stop playing or remove themselves from play. Help a child or youth immediately stop their physical exertion and help remove them from a situation where they could sustain a second injury before the first one heals. Assisting a player get to the bench and refusing them back into action is a great example.

The second step: a child or youth with a suspected concussion should be assessed and given a diagnostic decision by a qualified physician or nurse practitioner as soon as possible. You may find yourself in a doctor’s office, a walk-in clinic or an emergency room, but this initial medical assessment should occur to rule-out other conditions because some injuries can often be initially diagnosed as a concussion but may actually be more severe. When a concussion diagnosis is made, a course for recovery and potential treatments can be identified.

Does my child need follow-up after they are diagnosed with a concussion?

After a concussion is confirmed, follow-up care within 1-2 weeks by qualified health care providers is recommended by the Ontario Neurotrauma Foundation’s Standards for Post-Concussion Care. These Standards are the coordinated effort of leading scientists, clinicians, and advocates in the field of adult and pediatric concussions.

The good news is that majority of kids will recover from concussions within four weeks. For a child or youth with a straightforward recovery, all that may be needed following a concussion diagnosis is guidance from a qualified health care provider through a progressive, stepwise return to school and physical activities and education on symptom management. Not all people with a concussion require all the available interventions from providers.

However, it is hard to predict when a child or youth will experience a straightforward recovery from a concussion. Some kids will need more support than others. In any case, it is important that follow-up care is completed with a knowledgeable provider that possesses the training and experience to identify the appropriate recommendations for treatments or other resources.

Where should I go to get my child the right kind of help for their injury?

The current landscape of treatments for concussions, in and beyond this province, has been described as the “wild west.” Post-concussion care in Ontario is currently provided by a combination of publicly, third party and privately-funded services. With this in mind, knowledge of what to look for from a health care provider or clinic can be helpful.

The Standards for Post-Concussion Care by the Ontario Neurotrauma Foundation has made specific recommendations about healthcare providers and concussion clinics. Following this, the core functions and services of clinics treating concussions should include:

  • Diagnosis and medical treatment decisions
  • Physical treatment
  • Cognitive, functional, emotional support
  • Coordination of care
  • Education

Essential to any concussion clinic is access to a physician with experience in concussion management, who can provide ongoing involvement regarding medical stability, trajectory of care, potential need for medical specialty referral and decisions on clearance to return to activity.

Need help with a new concussion? Holland Bloorview’s Concussion Centre offers early care concussion services, specialized in helping children and youth get back to what they need, want, and love to do. The Early Concussion Care Program includes assessment, management, and clearance to return to school and sport.

For more information, visit www.hollandbloorview.ca/concussion.

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