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Advice on how to treat children under the age of 13 for concussion has changed in recent years. According to a comprehensive new research review, parents need to be made aware of the latest advice.

The research review, which was published in the Journal of the American Osteopathic Association, highlighted the move towards promoting an active recovery. It also stressed that parents need to understand that the recovery time for children who suffer a concussion is three times longer than for adults.

Dr Hallie Zwibel, DO, Director of Sports Medicine at New York Institute of Technology College and the study’s lead researcher, said that parents shouldn’t be alarmed that it can take up to four weeks for children to recover from a concussion.

This was echoed by behavioral and nuclear neurologist Gregory Hipskind, MD, PhD and InLight Medical Board Chairperson. “The results of this study are consistent with what we know about the developing brain in children,” he stated.

“This is a time of rapid development of synapses between neurons and a very vulnerable time to sustain the dramatic cellular metabolic changes that we now know are associated with mild traumatic brain injury, or concussion,” Dr Hipskind continued.

Although an active recovery is recommended for children who have suffered a concussion, the research makes it clear that a return to physical activity should be carefully monitored. Returning to the classroom after just two days is recommended, but physical activity should be introduced gradually and stopped if symptoms recur or worsen.

Being active can help alleviate symptoms such as dizziness and changes in vision. However, it’s essential that children are protected from suffering a second head injury during their recovery period from a concussion.

Dr Hipskind, who is a national expert in the evaluation and treatment of traumatic brain injury, explained why this is so important: “Second Impact Syndrome is an often fatal consequence of children under the age of 18 sustaining a concussion during the recovery period of a first concussion.

“Clearly, more time is needed for recovery in children along with the recommended active rehabilitation strategies highlighted by this latest research review,” he concluded.

In the review, Dr Zwibel is adamant that athletes should not compete while recovering from a concussion. However, he pointed out that “there’s not a good administrative structure to prevent an injured high school athlete from playing for another league”. This is why parents are so crucial in the recovery phase of a concussion.

They are in the best position to stop a child from competing before they’ve fully recovered from their injuries, he stated, adding that youth sport leagues should make sure they are following the latest return-to-sport guidelines.

Dr Hipskind agreed that children should avoid competitive sport while recovering from a concussion, but noted that it can be a challenge to get all of those involved to follow this advice. “The difficulty comes in getting school officials, coaches, and competitive parents and children to go along with the longer waiting and recovery stages outlined in this research,” he asserted.

Making sure the dangers of sustaining a second concussion during this recovery period are more widely known could help ensure children are given the appropriate amount of time to recover from a head injury and aren’t put at unnecessary risk by doing too much too quickly.