Concussion in Children and Youth in 2017: A Review of Current Guidelines and Research Findings and Their Relevance to Clinical Practice

Chair

Vicki Anderson

Presenters:

Audrey McKinlay
Ali Crichton
Silvia Bressan
Keith Yeates
 

Description:

By the age of 16 one in 20 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 utilisation.

Although awareness and concern over child concussion has grown dramatically over recent years, community knowledge of concussion remains limited. Many children do not attend for any medical care, and those that do often receive poorly integrated care and management with little reference to evidence based guidelines. Our understanding of recovery trajectories, predictors of outcome, appropriate assessment tools, and effective management and intervention remains limited. In response to these limitations, research on child and youth concussion using a developmental framework is receiving increased attention.

In the recently revised guidelines of the International Consensus of Concussion in Sports group (2016) for the first time, specific child concussion guidelines have been developed. This symposium will draw on these new child-focused concussion management recommendations and provide a comprehensive update on current research and clinical practice in child and youth concussion. The session will be divided into four topics:

1. Introduction: What do we know about child concussion.
    a. Definitions, epidemiology, mechanisms
    b. Community views and awareness
    c. Current consensus guidelines

2. Predictors of delayed recovery
    a. Acute presentatio
    b. Recovery trajectories
    c. Clinical decision rules
    d. Early post-concussive symptom cluster
    e. Biomarkers – neuroimaging, proteomics, genetics
    f. Psychosocial – child and family mental health, PTSD

3. Functional outcomes
    a. Fatigue
    b. Return to school, play
    c. Social participation
    d. Quality of life

4. Clinical assessment, management and treatment
    a. Models of effective and valid assessment
    b. Evidence on interventions – rest, psycho-education…

5. Limitations and future directions

 

Learning Objectives:

  1. Within an evidence informed framework, understand the current definitions of child concussion, the common presenting symptoms and their recovery trajectories.
  2. 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.
  3. Develop awareness of current evidence-based management guidelines and their implications for clinical practice.