Concussions in young children: Symptoms still present three months later

Concussions in children aged 6 and under continue to affect their health three months after the event. This is the finding of a study led by Miriam Beauchamp, a professor in the Department of Psychology at Université de Montréal and researcher at Sainte-Justine hospital.

Using a new measurement tool for young children, Beauchamp and her team demonstrated that early childhood concussions cause significantly elevated post-concussive symptoms that are not attributable solely to the general effects of the injury.

The three-month-post-event effects include known concussion symptoms such as headache, nausea, balance problems and drowsiness, but also behavioral symptoms unique to this age group, such as excessive irritability, increased crying and comfort-seeking.

The results were published in JAMA Network Open.

Well-documented effects

The consequences of concussion are well-documented in adults and school-aged children. But although a significant number of young children are seen in emergency rooms for concussions, little is known about the long-term consequences for them.

To gain a better understanding of post-concussion impacts, Beauchamp and her team evaluated 303 children between the ages of 6 months and 6 years, of whom 174 had been seen for a concussion, 60 had sustained an injury without a concussion, and 69 had no injury at all.

All were assessed using the Report of Early Childhood Traumatic Injury Observations & Symptoms (REACTIONS) inventory, a validated, toddler-friendly tool for measuring post-concussive symptoms.

The analysis showed that the children who had suffered a concussion had more symptoms than those with a limb injury or no injury, not only at the time of the initial visit to the emergency room but also ten days, one month and three months later.

Even three months after the concussion, these children had more physical symptoms, including headaches, sleep problems, fatigue, noise sensitivity and vision problems.

Clear guidelines needed

"The study highlights the importance of developing clear guidelines and an appropriate protocol for managing concussions in young children," Beauchamp said.

This study is the first to prospectively map the evolution of post-concussive symptoms in small children over a three-month period following a head injury, using a developmentally appropriate measure based on concrete observations.

The study's lead author, doctoral student Dominique Dupont said, "Our results suggest that the use of a tool ... such as the REACTIONS inventory, which can be used by parents as well as in a clinical setting, could help diagnose concussions and monitor symptoms in younger children."