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Stay aHEAD of the game: get the facts about concussion in sports.

Sports offer so many benefits to kids, from fun and fitness to responsibility and teamwork skills. But with sports also come bumps and bruises--and one type of injury requires much more than an ice pack or a band-aid.

Head trauma is one of the most common injuries sustained by young athletes, with more than 60,000 concussions occurring each year in U.S. high school sports, reports the American Council on Exercise.

The consequences can include impaired intellectual abilities, severe neurological disorders and other long-term disabilities.

That's why it's vital for parents, coaches and others who care for kids to better understand concussions, how to prevent them, and what to do when kids sustain them.

Understanding concussion

A concussion can occur in any sport, or from a simple fall or accident. It's a type of traumatic brain injury caused by either a blow to the head or a hit to the body that jolts the brain.

Sports concussions can be caused by colliding with another player, hitting the ground or other hard surface, or being hit by a piece of sports equipment. Concussions can even occur from body blows. Football players, for instance, can sustain concussions just from hits to the torso. Moreover, kids who've had prior concussions are at greater risk of sustaining another concussion, and are especially susceptible to hits that don't involve the head.

And while a bump to the head doesn't always cause a concussion, it's important to know the symptoms and when to seek care, in order to minimize kids' risks.

Ways to prevent and prepare

Parents and coaches play key roles in the prevention of sports concussions. They must educate athletes on proper techniques, good sportsmanship and the appropriate type of person-to-person contact, which will differ greatly according to sport.

Coaches need to know and instill correct techniques--whether it be tackling another football player properly, or learning the basics behind "heading" a soccer ball.

Coaches and their training staffs also have a responsibility to educate themselves about concussion so they can recognize the symptoms, communicate the dangers and promote safe play on the field.

Parents should stress the importance of reporting concussion symptoms to coaches immediately.

And everyone should be clear: if head trauma does occur, the athlete must be taken off the field and evaluated quickly. Such open dialogue with players is crucial, to help prevent long-term problems.

Above all, parents and coaches must insist that safety come first. Require the use of helmets and other protective equipment and techniques in both practice and game play. Teach sportsmanlike conduct and lead by example to foster an environment of healthy competition and team-oriented play.

What to look for

Concussions can be difficult to diagnose. They cause a range of symptoms, which can vary from person to person. Often student athletes don't report their symptoms for fear of being pulled from play or letting their teammates down.

Concussion symptoms include headaches, whiplash, tinnitus (ringing in the ears), nausea, indigestion, double vision, changes in information-processing speed, attention difficulties, slowed reaction time, changes in affect or mood, sensitivity to light (photophobia), agitation, irritability, and other behavioral changes.

Mild concussions are especially tough to identify and treat, because many athletes simply "get used to" the symptoms. The signs of a mild concussion can be noticeable days and even weeks following the actual event.

Severe concussions can bring more obvious symptoms. These may include a loss of consciousness, amnesia, severe thinking difficulties, impulsivity, obvious behavioral changes, memory problems, visual changes, and sensory confusion such as seeing sounds or hearing smells.

However, whether a concussion is considered "mild" or "severe," the long-term affects can't necessarily be predicted. A mild concussion, for instance, can have devastating lifelong affects on one person, whereas a severe concussion may clear up within a few days for someone else.

Where to turn

Following a suspected concussion, it is imperative that the child receive an evaluation by an experienced healthcare professional, typically a neuropsychologist or neurologist. The healthcare professional may employ a number of methods to assess a concussion's severity, such as "ImPACT" or "BESS."

With ImPACT (Immediate Post-Concussive Assessment and Cognitive Testing), it's necessary to have had a "baseline" test prior to the concussion. Parents should ask whether their child's school offers the test, or consider having one done privately each year for kids in contact sports.

The most widely used computerized concussion evaluation system, ImPACT should be administered within 24-72 hours after the injury. It involves testing of the individual's attention, vision, verbal memory, problem solving, reaction time and other related faculties.

The results of the test are then compared to those from the baseline test. If the results of the two tests are significantly different, the athlete must be pulled from the game, and he will not be eligible to return to physical activity until cleared by the appropriate professional. Because of its ease and convenience, ImPACT is often administered right on the field sidelines.

However, ImPACT alone cannot determine that a player did not sustain a concussion. Parents and coaches should continue to monitor the player and seek further interpretation from a neuropsychologist.

BESS (the Balance Error Scoring System) evaluates fine- and gross-motor (movement) abilities, as problems with these skills often indicate a concussion. This simple, objective test requires the person to stand on an unstable foam surface with his or her eyes closed, while the test-giver records errors such as opening one's eyes, leaning, falling and the like.

After the diagnosis

Concussion is typically treated with rest and avoidance of physical exertion, contact or further trauma to the brain. The neuropsychologist or neurologist should provide recommendations on care and recovery time, based on the evaluation results. Parents may need to change a child's activities or environment while he recovers, to prevent further concussions.

While most kids will be anxious to return to play, moms, dads and coaches must remain adamant that the child stay off the field during the recovery period. Only when the child has regained his previous health and abilities is it safe to return to the field.

Calls to action

Recognizing and responding appropriately to a concussion can help prevent further injury and long-term problems. Concussions are believed to have a cumulative effect. Their number, severity and frequency all play a role in the child's recovery. A history of concussions can increase one's risk for psychological and neurological disorders and can even be life-threatening.

Parents, schools and communities need to understand the risks associated with concussions. We may never fully know a concussion's impact on the mind and body, but new research shows significant and lasting effects--including links to depression and dementia--which should compel parents, schools and communities to pay more attention to kids' heads.

By working together, we can help keep our kids safe on the field.

With more than 20 years of experience as a clinician and administrator in neuropsychology and brain injury rehabilitation, Dr. Cynthia Boyer is senior clinical director of Brain Injury Services at Bancroft, a leading area nonprofit organization serving people with neurological challenges. She is also an adjunct faculty member of Rowan and Widener universities and Philadelphia College of Osteopathic Medicine. A licensed clinical psychologist in Pennsylvania and New Jersey, Dr. Boyer serves on the boards of both the Academy of Brain Injury Specialists and the Brain Injury Association of New Jersey.

Concussion Symptoms

Mild concussion can cause the following symptoms up to several weeks after the injury:

* severe headache

* ringing in the ears

* nausea

* indigestion

* double vision

* attention difficulties

* slowed reaction time

* changes in affect or mood

* sensitivity to light

* agitation

* irritability

Severe concussions may also involve:

* loss of consciousness

* amnesia

* severe thinking difficulties

* impulsivity

* behavioral changes

* memory problems

* visual changes

* sensory confusion, such as seeing sounds

Concussions: Prevent and Prepare Talk to your kids' coaches about concussion risks and prevention

* Require athletes to use proper techniques for tackling, heading balls and other forms of contact.

* Have kids practice good sportsmanship--no hits to heads!

* Report concussion symptoms immediately.

* If concussion is suspected, stop playing and seek immediate evaluation.

By Cynthia Boyer, Ph.D.
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Author:Boyer, Cynthia
Publication:The Exceptional Parent
Geographic Code:1USA
Date:Mar 1, 2011
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