As a Speech-Language Pathologist specializing in Neurological Rehabilitation, most of my days are consumed with assessing and treating teens and adults that have been affected by brain injuries. Although brain injury can take many forms, one of the most common types is TBI, or Traumatic Brain Injury. A TBI is a blow or jolt to the head or a penetrating head injury that disrupts normal function of the brain. Symptoms include headaches, motor dysfunctions, sensory changes, attention and concentration difficulties, loss of memory, word-finding and fluency issues, among others. Not so fun, huh? How do we keep our kids safe?
Annually there are 500,000 admissions to hospitals due to brain injury. 200 per 100,000 people are affected. The most popular occurrence is among pre-school age children and 15-25 year olds, with falls dominating the younger range and motor vehicle and sports related injuries dominating the teen and young adult ages.
For the pre-school aged child, it is important to follow all car seat safety regulations without fail. These vary from state to state, so check your state laws to keep your kids safe. Ironically, some of these accidents happen outside of the car when kids are not buckled properly into their seats, and then when picked up, fall out. Although personally embarrassing to admit, I had my child strapped into a vibrating chair watching me cook once when the chair vibrated right off the counter. Another child rolled off the middle of my bed while I was standing right next to it trying to change. Thankfully, both were safe and head injury free. However, these are some common pitfalls. Also try to avoid sharp corners on tables or exposed edges when those little ones are learning to walk. If possible, keep them in a carpeted area during the “new walker” stage. Your kids will fall down and hit their heads. I am not sure how many little raspberries I saw on my boys, but there were plenty. Unless the crying ceases to stop and you notice other changes, they are most likely fine. If you do fear a concussion, contact your pediatrician.
From the ages of three to seven, kids move on to scooters, bikes and more. A helmet should be worn at all times while engaging in these activities. Furthermore, it is important to make your kids aware of local traffic laws. Biking always occurs with traffic, and at this age, preferably on the sidewalk. As they get older, and the bikes get bigger and more advanced, the bike lane is probably most suitable. One common occurrence during our family bike rides is that cars usually fail to see bikes when they are backing out of driveways. So, if your kids are biking on the sidewalk, it is important to talk to them about running cars and noticing brake lights.
On to the teenage years. Of course head injuries from MVA’s (Motor Vehicle Accidents) are quite common and lead in statistics. Always, always, encourage them to wear their seat belts. However, even more disturbing is the increase in sports related head injuries, which account for 21% of all TBIs. Why is the incidence increasing and what can we do about it? Well, one reason is that sports are starting younger and younger and are much more serious than when I was growing up. Tackle football at 8? Club soccer starting at 7? Repeated jolts to the head over time in both of these sports can lead to serious problems.
The American Football Association created a task force to decrease head down contact. Apparently, our helmets have become so padded and feel so safe that kids are often leading into tackles with their head, and repeatedly over time, this can have serious ramifications. At the high school level, 10-15% of athletes sustain concussions and only a fraction of those are receiving proper treatment. Just now, more rules are being made regarding pre and post season physical and cognitive exams to help determine if there is a concussive syndrome that has lead to a mild TBI. Just last week I saw a college athlete in my office from a division II school that had been playing tackle football since he was 8. Again, he has not even gone pro yet and is exhibiting memory loss, attention and concentration and headaches. He is constantly fatigued and struggling in school.
One common injury in soccer occurs with repeated “heading” of the ball. Sixty percent of college level soccer players reported symptoms of concussion during a single season. There have been some head gears that have been developed to help alleviate this problem, but as of yet, all have been claimed ineffective.
Despite my career, I am not a worrier by nature and encourage my kids to be as physically active as possible. However, I would encourage all parents to think long and hard about at what age and what intensity our kids should be involved in these sports. I have two boys, and we love sports in our house. So I do what I can do to prevent some injuries (i.e. helmets and seat belts), and we have made the decision (despite some protests) not to start tackle football until at least the junior high years. It’s flag until then. Every family is different and certainly starting these sports at an early age does not guarantee a head injury. This is what feels right for us; so do what you can to keep your kids safe and do what feels right for you.