Research In Action

Minds Matter has published new research that provides a comprehensive analysis of the characteristics of concussion in young children. While systematic reviews of pediatric concussion research—such as the most recent International Consensus Statement on Concussion in Sport—have provided guidance and evidence-based best practices that have advanced treatment and knowledge across the globe, they have mostly excluded research outside of sport-related concussion, which may be particularly important in younger age groups, where unstructured free play is common. 

Led by Tricia Roby, PhD, ATC, our former postdoctoral fellow, the intent of this new research was to address knowledge gaps in terms of the source of injury for younger-aged children while considering factors such as demographics, a patient’s entry point to care, and clinical characteristics. 

For this study, we evaluated 1,141 patients between the ages of 5 and 12, who presented to a CHOP specialty care concussion setting within 28 days of injury. Our analysis found that recreation-related concussion (RRC, 37.3%) was the most common reason for a child’s visit, followed by non-sport or recreation-related concussion (non-SRRC, 31.9%), and then sport-related concussion (SRC, 30.9%). 

Why This Distinction Is Important 

Knowing how concussion patients in this age group sustain their injury can guide interventions that ultimately lead to better health outcomes. Recreation-related concussions and those occurring outside of sports and recreation are different than those occurring on the sports field, where the injuries are almost always observed and the plan and path to care is clear. 

Importantly, our analysis shows patients with RRC and non-SRRC mechanisms take longer to seek medical care (2 to 3 days). When they do, it is often first at a primary care or emergency department setting, rather than with a concussion specialist. When considering previous research that shows delays in care and targeted rehabilitation are key contributing factors to prolonging recovery for concussed children, it becomes even more clear that a better understanding of where the injury occurs within this younger age group is important. 

Informing Policy and Best Practices 

This study’s findings shine a light on the significance of education and up-to-date information for anyone—not just athletic trainers or youth coaches—who may be the first point of contact for a young child presenting with concussion. Engaging school nurses, as one example, about these findings can serve as a starting point to overcome barriers to, and disparities in, care that contribute to worse health outcomes in younger populations. They can serve as a hub of information and coordination for both initial recognition of concussion and then ultimate return to academic and physical activity. 

Our Minds Matter Concussion Program Model, built from existing research, education, and training, seeks to address and reduce disparities that exist because of those gaps in information and education across various settings. We continue to explore research opportunities that allow us to understand concussion more comprehensively within this younger age group which will help level the playing field—even when it’s not a sports field—in terms of concussion treatment and recovery for children everywhere.