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Concussion awareness among children and their care givers

Published:April 24, 2018DOI:https://doi.org/10.1016/j.ajem.2018.04.048
      Recently, there has been considerable public interest in sport-related concussions and their outcomes, resulting in a substantial multidisciplinary focus on concussion prevention and a push for greater public awareness [
      • Kirkwood M.W.
      • Randolph C.
      • Yeates K.O.
      Sport-related concussion: a call for evidence and perspective amidst the alarms.
      ,
      • Kirkwood M.W.
      • Yeates K.O.
      • Wilson P.E.
      Pediatric sport-related concussion: a review of the clinical management of an oft-neglected population.
      ,
      • Randolph C.
      • Kirkwood M.W.
      What are the real risks of sport-related concussion, and are they modifiable?.
      ]. The incidence of adolescent sport-related concussions is based on diagnosis as reported by physicians, athletic trainers, coaches, and other care providers. However, it is unclear if the symptoms of concussion or the types of injuries that cause concussion are easily recognizable by children or their caregivers [
      • Halstead M.E.
      • Eagan Brown B.
      • McAvoy K.
      Cognitive rest following concussions: rethinking 'cognitive rest'.
      ,
      • Halstead M.E.
      • Walter K.D.
      • Council on Sports, M. & Fitness
      • American Academy of Pediatrics
      Clinical report–sport-related concussion in children and adolescents.
      ,
      • Harmon K.G.
      • et al.
      American Medical Society for Sports Medicine position statement: concussion in sport.
      ,
      • Walter K.D.
      • Halstead M.E.
      Concussion in teenage athletes.
      ,
      • Echlin P.S.
      • et al.
      The Sport Concussion Education Project. A brief report on an educational initiative: from concept to curriculum.
      ,
      • Echlin P.S.
      • et al.
      Return to play after an initial or recurrent concussion in a prospective study of physician-observed junior ice hockey concussions: implications for return to play after a concussion.
      ]. As a result, many potential concussions go unreported, and some athletes continue to play while symptomatic, leading to worsening injury and greater burden of disease [ ,
      • Omalu B.
      Chronic traumatic encephalopathy.
      ,
      • Iverson G.L.
      • Gaetz M.
      • Lovell M.R.
      • Collins M.W.
      Cumulative effects of concussion in amateur athletes.
      ]. Recent guidelines recommend that concussed athletes be removed from play and have a gradual return to play once asymptomatic [
      • Lovell M.R.
      • Fazio V.
      Concussion management in the child and adolescent athlete.
      ,
      • Majerske C.W.
      • et al.
      Concussion in sports: postconcussive activity levels, symptoms, and neurocognitive performance.
      ]. Both recognition of the symptoms characteristic of concussion and receipt of timely post-concussion care are important, and numerous legislative efforts have been made with some positive effect in this regard [
      • Gibson T.B.
      • Herring S.A.
      • Kutcher J.S.
      • Broglio S.P.
      Analyzing the effect of state legislation on health care utilization for children with concussion.
      ,
      • Trojian T.
      • Violano P.
      • Hall M.
      • Duncan C.
      The effects of a state concussion law on the frequency of sport-related concussions as seen in two emergency departments.
      ,
      • Tomei K.L.
      • Doe C.
      • Prestigiacomo C.J.
      • Gandhi C.D.
      Comparative analysis of state-level concussion legislation and review of current practices in concussion.
      ,
      • Shenouda C.
      • Hendrickson P.
      • Davenport K.
      • Barber J.
      • Bell K.R.
      The effects of concussion legislation one year later--what have we learned: a descriptive pilot survey of youth soccer player associates.
      ,
      • Baker D.R.
      • Kulick E.R.
      • Boehme A.K.
      • Noble J.M.
      Effects of the New York State Concussion Management and Awareness Act (“Lystedt Law”) on concussion-related emergency health care utilization among adolescents, 2005–2015.
      ].
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