Pediatric Concussion Evaluation

The initial concussion evaluation includes:

• A health history review.
• A comprehensive review of the child’s injury and symptoms.
• A thorough physical and neurological examination. 
• Age-appropriate neurocognitive testing, which may include when deemed clinically appropriate:
• ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing)
• SYSTEMS (School-Years Screening Test for the Evaluation of Mental Status) 
• A static postural stability assessment using the Balance Error Scoring System (BESS).
• Education and counseling for the patient and family regarding concussion risk factors, what to expect throughout the recovery and strategies for injury prevention.
• An individualized treatment plan, including management of symptoms and recommendations for when and how to safely return to school work and physical activities.
• Assistance with establishing academic accommodations through 504 plans and individualized education plans (IEPs) when needed.
• Referrals to clinical and neuropsychologists are facilitated when necessary to assist with management of prolonged cognitive and emotional symptoms.  
• Consultation with appropriate physical, occupational and speech therapists, when necessary for management of specific symptoms.
• Vestibular therapy uses a multifactorial approach to manage persistent dizziness, visual symptoms and balance problems in children and adolescents with post-concussion syndrome. Physical therapists trained in vestibular therapy techniques teach exercises to re-train specific reflex systems that improve balance and can decrease dizziness. Guided and progressive cardiovascular training and sport-specific coordination drills can improve vestibular function while making children more confident about their return to regular activities. Physical therapists can also give soft tissue massages and stretching for neck muscles and posture training, which can reduce neck pain and headaches.
  Learn more about our Vestibular Rehab Program.
• The symptoms associated with concussion and post-concussion syndrome can have an impact on functional performance. Occupational therapy can provide a unique role in assisting with:
  
  • Evaluation of functional cognition in the areas of memory, attention, sequencing, organization/planning and problem solving
  • Education on and strategies for symptom management
  • Gradual increase in cognitive demands for reintroduction to full participation in school, extracurricular and home activities
  • Compensatory and rehabilitative strategies for cognitive symptoms

After the evaluation and consultation, our specialists will recommend an individualized treatment plan and take time to answer any questions.

Our medical providers work with patients and coaches to develop a schedule for safe progression back to physical activities. This progression takes a minimum of five days.

Students usually recover from a concussion within three weeks. Those with severe symptoms may need to stay home after a concussion; those with mild or tolerable symptoms may return to school with some adjustments.