Parents and Youth Coaches Taking Charge of the Youth Concussion Issue

Gerard A. Gioia, PhD, Children's National
Parents and Youth Coaches Taking Charge of the Youth Concussion Issue

As a parent, with all the current media attention given to concussions, it is hard not to be worried and to question your child’s involvement in sports, especially contact sports. On the positive side, youth sports are a wonderful place for children to learn important life lessons. As a society, we want our children to be active in sports, stay healthy, and enjoy all their positive benefits. There are many things a youth sports league, its coaches, and officials can be doing to maximize the benefits of the experience and minimize the risk. While there is a risk in any sport, if coached and played with head safety in mind, the benefits will likely far outweigh the risk. By arming oneself with proper concussion knowledge and skill, parents and youth coaches can feel more in charge of this injury, thereby increasing their confidence in allowing their child’s active participation in sports. To safeguard children from concussion, parent and coach responsibilities include:

  1. Obtain education on concussion signs & symptoms, and risks
  2. Develop skills to recognize signs & symptoms, and respond appropriately
  3. Obtain appropriate post-injury medical evaluation and support symptom management at home and school
  4. Understand the need for return to sport participation only with proper, written medical clearance.

In youth sports, trained medical professionals are typically not on the sidelines. Parents and youth coaches, therefore, have an important responsibility to recognize when a child may have sustained a concussion on the playing field, and respond appropriately. While the general public has become more aware of concussions over the past five years, many lack the basic information about what to do next when a concussion is suspected. Parents and coaches may ask the question:How will I remember what to look for if I suspect a concussion and what should I do?” It is important to feel confident in recognizing the signs and symptoms of concussion and to take the proper action steps to prevent further injury.

What Every Parent and Youth Coach Should Know — and Do

The following are six action steps we strongly encourage parents take:

  1. Learn how to recognize a concussion. To recognize a concussion, you are looking for two things:
    1. A blow to the head or to the body that moves the head violently, and
    2. Any sign or symptom that indicates a change in the child’s physical, cognitive, emotional function or behavior. For further information and education, we recommend parents view one of the online educational videos on concussion (e.g., CDC’s Concussion Training , the AcTIVE concussion training program, or one of the sport-specific videos (football, lacrosse, ice hockey) made by the National Academy of Neuropsychology and the National Athletic Trainer’s Association
  2. Learn the 12 Danger Signs of brain injury. There are 12 danger signs of a brain injury that, although relatively uncommon, require immediate emergency medical attention if they are observed or suspected. Call 911 immediately if any of these signs are present.
  3. Remove the child from play if you suspect a concussion, and obtain a medical evaluation. Any blow to the head, no matter how mild, can cause a concussion. Look for the associated signs and symptoms. It is better to be safe than question if they should return to the game. Treat all concussions as serious. If you suspect a concussion, call your child’s pediatrician and ask if he or she would prefer to examine your child or if you should go to the emergency room. Do not try to judge the seriousness of the injury yourself. Second-impact syndrome, though rare, occurs when an individual sustains a second concussion before the first has properly healed, and can be severely disabling or even lead to death.
  4. Support proper treatment. After a concussion, the individual’s brain should not be over-stimulated or subjected to any further risk of re-injury. The less “work” the brain has to do, especially early in recovery, the more energy it can put toward healing. During recovery, it is important to provide a careful balance between activity and rest, not allowing the symptoms to worsen. Managing the child’s physical and cognitive (school) activity is very important throughout recovery.
  5. Use tools to guide your recognition and response. The CDC materials are excellent, either in paper form or via the Concussion Recognition & Response (CRR) app to help guide your recognition of the signs and symptoms. (
  6. Monitor and record the child’s symptoms at home as is recommended by the CDC. The Home Symptom Monitoring feature of the CRR app can assist you to track symptom progress and provide this valuable information to assist post-injury treatment.

Ten Questions to Ask Youth Sports Organizations

In whatever sport a child chooses, to feel more comfortable and confident with their participation as it relates to concussion risk, parents must do their homework and ask questions of the league and coaches about how they handle head safety. A parent needs to feel at ease that the safety is a priority. We encourage parents to ask these 10 questions. We encourage youth sports organizations to properly prepare themselves for these questions.

  1. Does the league have a general policy in how they manage concussions?
  2. Does the league have access to healthcare professionals with knowledge and training in sport-related concussion?
  3. Are the coaches required to take a concussion education and training course?
  4. Who is responsible for the sideline concussion recognition and response to suspected concussions during practice and games?
  5. Do the coaches have readily available the tools — concussion signs & symptoms cards, clipboards, fact sheets, smartphone apps, etc. - during practice and games to guide proper recognition and response of a suspected concussion?
  6. Does the league provide concussion education for the parents, and what is the policy for informing parents of suspected concussions?
  7. What is the policy regarding allowing a player to return to play? [Correct answer – when an appropriate medical professional provides written clearance that the athlete is fully recovered and ready to return.]
  8. Does the league teach / coach proper techniques (e.g., blocking and tackling in football, checking in hockey and lacrosse) in a way that are “head safe” by not putting the head in position to be struck? If the player does demonstrate unsafe technique during practice or a game, do the coaches re-instruct them with the proper technique/ method? Is head and neck strengthening taught?
  9. If a contact sport, are there limitations to the amount of contact? How often (# days per week, # minutes per practice) do you practice with live contact? Is that any different than past years?
  10. How amenable is the league/ team / coach to accepting feedback from parents about their child’s safety as it relates to head safety?
Posted on BrainLine January 27, 2014.

Used with permission from Gerard A. Gioia, PhD, pediatric neuropsychologist, director, Safe Concussion Outcome, Recovery & Education (SCORE) Program, Children's National.