Multimodal evaluation and management of children with concussion: Using our heads and available evidence

Abstract

Background: Significant attention has been focused on concussions in children, but a dearth of research evidence exists supporting clinical evaluation and management.

Aim: The primary objective of this review paper is to describe a multimodal, developmentally adapted, standardized concussion assessment and active rehabilitation approach for children as young as 5 years old.

Methods: This study reviews the CDC-funded research programme, including the development of tools for post-concussion symptom assessment involving the child and parent, measurement of specific neurocognitive functions and assessment of dynamic cognitive exertional effects.

Results: A clinical approach to active, individualized, moderated concussion rehabilitation management is presented, including a 10-step guide to symptom management, with a specific focus on the school challenges faced by the recovering student.

Conclusion: To better inform concussion practice across the developmental age spectrum, a significant need exists for further research evidence to refine clinical assessment methods and develop effective treatment approaches.

• Assessment
• concussion
• children
• mild traumatic brain injury
• rehabilitation

Declaration of interest

I declare that I am a co-author of the Acute Concussion Evaluation (ACE), Post-Concussion Symptom Inventories (PCSI), Multimodal Assessment of Cognition & Symptoms for Children (MACS), and Exertion Effects Rating Scale (EERS). The work reported in this paper was supported in part by grants from CDC no. U17/CCU323352-01 and NIH no. 5-MOI-RR-020359-02. I have received no financial remuneration for the development of the above tools.