Concussion in Children and Youth in 2017: Current Evidence and its Relevance to Evidence-based Practice
CHAIR
PRESENTERS
DESCRIPTION
By the age of 16 one in 3 children will have sustained a concussion, with concussive injuries comprising up to ¼ of presentations to pediatric emergency services. Although inconsistent, current evidence suggests that somewhere between 20 – 50% of these young people will experience persistent post-concussion symptoms that hinder their return to normal activities. These symptoms, which include headache, dizziness, fatigue, cognitive complaints, and emotional disturbance, frequently result in reduced quality of life and high levels of heath care utilization.
Although community awareness and concern over child concussion has grown dramatically over recent years, our understanding of recovery trajectories, predictors of outcome, appropriate assessment tools, and effective management and intervention remains limited. Previous evidence, showing that injury to the young, developing brain leads to slower recovery than that seen in adults, implies that research findings and clinical management guidelines employed for adult concussion may not adequately address the needs of children and youth with concussion. In response to these limitations, research on child and youth concussion using a developmental framework is receiving increased attention.
This symposium will provide a comprehensive update on current research in child and youth concussion and implications for clinical management and intervention. The session will be divided into four topics:
- Introduction: What do we know about child concussion.
a. Definitions, epidemiology, mechanisms
b. Acute presentation
c. Effective and valid assessment of acute and chronic symptoms
d. Recovery trajectories
e. Early post-concussive symptom clusters - Predictors of delayed recovery:
a. Clinical decision rules
b. Biomarkers – neuroimaging, proteomics, genetics
c. Psychosocial – child and family mental health, PTSD - Functional outcomes
a. Fatigue
b. Return to school, play
c. Social participation
d. Quality of life - Clinical management guidelines and interventions
a. Current consensus guidelines and effective implementation
b. Evidence on interventions – rest, exercise, psychoeducation - Limitations and future directions
LEARNING OBJECTIVES
- Within an evidence informed framework, understand the current definitions of child concussion, the common presenting symptoms and their recovery trajectories.
- Understand the range of factors (clinical, physical, mental health, environment) that contribute to delayed recovery following child concussion, in order to i) better predict those at risk for delayed recovery and ii) provide accurate information regarding prognosis and need for intervention.
- Demonstrate awareness of effective post-concussion psycho-education and interventions for children suffering concussion.
