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Concussions: How Much Do You Know to Protect Your Teen?

5. Yes or No
After another player at a football game slammed my 16-year-old, he told the coach that he felt "off." The coach pulled my son aside and asked him how many fingers he was holding up. But isn't that test too simple to determine whether it's safe to return to the field?

The so-called sidelines test can't detect if your child has suffered a concussion. "Coaches shouldn't make that call," says Dr. Walter. "What they should do is know the signs—feeling 'off' is one of them—and get the child appropriate treatment if they suspect head trauma." That means having an athletic trainer or medical professional perform a physical exam and a series of cognitive tests, including repeating sets of words or numbers backward. If the child answers correctly, there's no immediate need for a doctor, but he should sit out the rest of the game and be rechecked every 10 to 15 minutes, since symptoms can appear later. ANSWER: YES

6.True or False
My daughter wears a helmet when she plays field hockey, so I can rest assured that she's safe from harm.
Helmets and mouth guards can prevent facial, tooth and skull fractures, but they do not protect the brain against concussions. Your child should always wear a helmet appropriate to the activity she's involved in, even if it's not a contact sport. Check the label to verify that the helmet meets federal and/or voluntary safety standards. Make sure it fits snugly and that the chinstrap is fastened. ANSWER: FALSE

7. Yes or No
My 15-year-old daughter got a concussion playing soccer 10 days ago. Her coach says she can return to the team. Should I let her?

Only a qualified doctor can make that assessment. Currently 43 states have sports concussion laws, most of which require that school-age athletes diagnosed with a concussion get written authorization from a medical expert before they play again. "Problem is, each state has a different definition of who can do the clearance," according to Dr. Walter. "Some say a licensed health care professional, which could be a nurse or chiropractor but she needs up-to-date education in concussion care." What you want your child to avoid at all costs is second-impact syndrome—being subjected to another blow to the head during the crucial period shortly after sustaining the first concussion. "That can be a fatal combination," Dr. Walter says. "The syndrome is rare, but it does happen." Young people may also be prone to post-concussion syndrome, in which they have persistent symptoms like headaches, irritability and dizziness. Unfortunately, among parents of children ages 12 to 17 who play school sports, less than 10% have read or heard about the risk of repeat concussions, according to a 2010 survey. And experts don't know how long this vulnerable period lasts or what the best treatment is. One common therapy is cognitive rest—avoiding mental and sensory stimulation, including bright lights and loud noises as well as video games and TV—for about two weeks. It may well be longer before it's safe for your child to play again, so consult a pediatrician and a specialist. ANSWER: NO

8. True or False
Kids rebound from concussions more quickly than adults.
This is one of the few injuries where the younger you are, the longer it takes to recover. That's because the adolescent brain is still developing and therefore more vulnerable. Girls are particularly at risk. According to research, high school girls playing the same sports as boys have higher rates of concussion, more symptoms and greater declines in visual memory. As for recovery, there is no standard timetable. It varies according to the individual, the incident that caused the injury and whether the child has pre-existing conditions or had a previous concussion. "Clinical observations suggest that the majority of preteens and teens recover in two weeks, compared with the one week that we see in adults," says Dr. Kutcher. But the sobering fact is that as many as one in five children with a concussion suffer diminished higher-order reasoning skills comparable to those who've had severe brain injuries, in some cases lasting as long as two years or more. ANSWER: FALSE

SCORECARD
If you answered correctly: 7-8 questions Congratulations on being so well informed. At the next game, share your knowledge with other parents while watching from the sidelines.
5-6 questions You're on your way to becoming concussion savvy.
4 or fewer It's time to start studying so you can learn how to prevent, recognize and respond to a concussion. Learn more from your pediatrician or take a free online course at cdc.gov/concussion.