Recognizing the Signs and Symptoms of Concussion in Children and Youth

Recognizing the Signs and Symptoms of Concussion in Children and Youth

By Marilyn Lash, M.S.W.

Who needs to know the signs and symptoms of a concussion in children at school? The answer is simple – everybody, that’s who. A concussion is a mild brain injury. Whether a student is in elementary, middle or high school, it’s important to closely monitor the effects of a concussion and the student’s recovery.

It’s not up to just the parents, physician or coach. Everyone who has contact with the child and student can be part of the managing team in the athlete’s neighborhood. This includes coaches, athletic trainers, parents, physicians, teachers, school nurses and school psychologists. They all have a role in monitoring and helping the student’s recovery.

Appearances can be deceptive after a concussion

A student-athlete may have no visible signs of injury, but this does not mean that there has not been a concussion.The following changes are indicators that a student-athlete may have sustained a concussion and should be examined:

  • vacant stare
  • easily distracted
  • difficulty answering questions
  • disorientation
  • slurred speech
  • lack of coordination
  • memory impairment or loss
  • highly emotional
  • any period of loss of consciousness 

Many people assume that a blow to the head is not serious if the child or youth does not lose consciousness. There is usually no loss of consciousness when a child or youth has a concussion. If it does occur, it is often just seconds or minutes. However, the youth’s brain can still be injured by a concussion without a loss of consciousness.

Help for the student athlete with a concussion

Many people can help a child or youth who is injured at home, at school, on the playground, during a game, or in a team sport. They are listed next.

  1. Physician – It is very important for parents to always tell a child’s pediatrician or family physician about any concussion that is suspected or identified, no matter how minor it may seem. The child’s physician can advise on how to monitor a child’s recovery and determine when it is safe to resume activities. Following a physician’s advice can help a child recover and prevent another injury.
  2. Parents – Parents know their child better than anyone. Any injury to a child’s head, face or jaw has the potential to be dangerous. Parents should talk with the physician about how to monitor their child immediately after the concussion. It’s also important to always check with a physician before giving any medication to a child after a concussion. Parents are in the best position to closely watch their child for any signs of change including worsening headaches, weakness, numbness or decreased coordination, repeated vomiting, difficulty waking, unequal eye pupil size, convulsions or seizures, slurred speech, increased confusion, restlessness or agitation. Any of these changes require medical attention.
  3. Friends – They may be the first to noticethat “something just isn’t “right” with their friend. They may have seen their friend fall or be hit. The concussion may not have been diagnosed yet, but close friends may see changes that are signs of a concussion. Friends can help by telling parents, school nurses or athletic trainers about the changes they have noticed.
  4. Teachers – There are many ways that a concussion can affect a student in school. Difficulty concentrating, remembering new information or getting along with classmates are just a few changes often seen after a concussion. Teachers can help the student during the recovery process by reducing assignments, building in rest periods, and giving more time to finish assignments or homework.
  5. School nurses – The school nurse can be a helpful and informative resource for both the student as well as parents, educational and athletic staff. By identifying and recording symptoms of a concussion in a student-athlete, the school nurse can monitor the child’s progress, identify problems and communicate with parents.
  6. Coaches – The coach is responsible for protecting the athlete’s health and safety whenever a concussion is suspected or has been diagnosed. Every coach should be aware of the signs and symptoms of concussion and guidelines for the student-athlete’s safe return to play. Many players do not report concussion symptoms, because they do not want to be removed from a game or practice. This places additional responsibility on coaches for awareness of any signs of concussion.
  7. Athletic trainer – The athletic trainer is a valuable resource for the student-athlete, parents, and all others involved in the school system. The athletic trainer has special training about concussion and guidelines for play. By insisting on safety first and participation second, the athletic trainer can communicate and coordinate information as the student’s recovery progresses.


There is nothing minor about a concussion. It affects the brain and must be monitored carefully. Everyone in the child’s world and the student’s environment has an important role in the recognition of a concussion and in supporting the student’s recovery.  

For more information, see the tip card Concussion Education in the Student-Athlete’s Neighborhood by Phil Hossler.

Recommended Reading

Getting A-Head of Concussion

By Phil Hossler, A.T.C.







School Sports Concussions in Children and Teens

By Phil Hossler, A.T.C., Jeanne Dise-Lewis, Ph.D., Marilyn Lash, M.S.W., Roberta DePompei, Ph.D., Ron Savage, Ed.D.

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