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I know many well-meaning parents who are guilty of allowing their child to be rushed back into contact sports following a concussion. Whether the concussion is suffered in a car accident or a sports-related incident, the same issue typically arises- the child wants to go back to sports immediately after getting checked out at the hospital. I know enough about mild brain injury to know this is usually a bad idea, particularly for children who have had multiple concussions. I’ve often struggled with the internal debate between not wanting to interfere with another family’s decision and knowing that one can suffer mild brain damage that may not show up on the hospital CT scan. I now have a new study to cite to fellow parents.

Using a computer-based training program created to assess athletes with concussions and determine when it was safe for them to return to sports, researchers at The Children’s Hospital of Philadelphia followed 116 children at an urban Level 1 trauma center over two years. The tests revealed an alarmingly high rate of cognitive deficits in nearly all patients during initial testing. The program tests specific abilities, such as attention span, memory, nonverbal problem solving and reaction time. Almost all patients tested below the 25 percentile in at least one area; the majority demonstrated significant impairment for all four subtests.

The test also assesses the degree of concussion symptoms, and the majority of children with concussions demonstrated an abnormal symptom score. The follow-up group demonstrated significant improvement in neurocognitive performance on all four subtests as well as an improvement in their symptom scores. Prior research has demonstrated that children are more likely to sustain another concussion if they return to sports or exertional activities prematurely. In addition, high school athletes recover more slowly than college or professional athletes. Presumably the same is true for children with concussion from non-sports related causes.

The authors of this study recommend that a qualified healthcare provider perform a formal assessment after hospital discharge and before a concussed child is allowed to resume exertional activities, particularly contact sports. The referenced article appears in the May issue of the journal, Annals of Surgery.

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