Traumatic Brain Injuries and Children in School: What Parents, Teachers, and Coaches Should Know

A new school year means new classrooms, new teachers, Friday night football, soccer practice, recess, physical education, cheerleading, playgrounds, and countless opportunities for children to be active.

It also makes this an important time to talk about traumatic brain injury (TBI) and concussion awareness.

At the Children’s Advocacy Centers of Cameron and Willacy Counties (CACCWC), our work is centered on the safety and well-being of children. Part of creating safer communities is making sure parents, educators, coaches, caregivers, and other trusted adults have the information they need to recognize when a child may need help.

A head injury can happen in seconds. Recognizing the signs and responding appropriately can make an important difference in a child’s recovery.

Learn the signs of traumatic brain injury and concussion in children, what parents and coaches should watch for, and how to keep students safer during school sports, recess, and activities.

What Is a Traumatic Brain Injury?

A traumatic brain injury occurs when a bump, blow, or jolt to the head—or a hit to the body that causes the head and brain to move rapidly—disrupts normal brain function. A concussion is a type of traumatic brain injury, and its effects can influence how a child thinks, learns, feels, behaves, and sleeps.

One important misconception parents should understand is that a child does not have to lose consciousness to have a concussion.

A student may walk away from a collision, continue playing, or return to class while still experiencing a brain injury. Some concussion symptoms also may not become noticeable until hours or even days after the injury.

That is why awareness among the adults surrounding a child is so important.

Where Can Head Injuries Happen at School?

When we hear the word "concussion," many of us immediately think about football.

But traumatic brain injuries aren't limited to football players or even organized sports.

A child could suffer a head injury during:

• Football, soccer, basketball, volleyball, baseball, softball, or other sports

• Cheerleading or gymnastics

• Physical education

• Recess

• A fall from playground equipment

• Running or playing with classmates

• Bicycle or scooter accidents

• A fall in a hallway or on stairs

• After-school activities

This means concussion awareness isn't only for coaches. Teachers, parents, school nurses, playground supervisors, caregivers, and other trusted adults should know what to watch for.

What Does a Concussion Look Like?

One of the challenges with concussions is that there isn't always an obvious physical injury.

There may be no cut, bruise, or visible indication that something is wrong.

Instead, parents and school personnel may notice that a child simply isn't acting like themselves.

According to the CDC, concussion symptoms can include headaches, dizziness or balance problems, nausea or vomiting, vision problems, sensitivity to light or noise, fatigue, difficulty concentrating, memory problems, feeling foggy, irritability, anxiety, sadness, and changes in sleeping patterns. CDC

For school-age children and teenagers, adults may also notice that the student appears dazed or confused, answers questions more slowly than usual, suddenly struggles to remember or concentrate, or seems unusually clumsy or unsteady. CDC

That's why knowing what is normal for a particular child can be so valuable.

Sometimes the Signs Show Up in the Classroom

A head injury doesn't stop affecting a child when they leave the playing field.

The classroom may actually be where some symptoms become more noticeable.

After a concussion, a student may suddenly struggle to concentrate, remember new information, follow instructions, complete assignments, make decisions, or tolerate bright and noisy environments. Teachers may also notice irritability, fatigue, withdrawal, or difficulty managing stress. CDC

A student who normally completes an assignment quickly may suddenly need much longer.

A child who normally participates in class may become quiet.

A teenager who usually performs well academically may suddenly have trouble focusing.

These changes shouldn't automatically be dismissed as laziness, lack of motivation, or behavioral problems—particularly if the child recently experienced a fall, collision, or blow to the head.

Parents: Get to Know the Adults Around Your Child

Back-to-school season is a perfect opportunity to introduce yourself to the adults who spend time with your child.

Know their teachers.

Meet their coaches.

Know their PE teachers, athletic trainers, counselors, and other school personnel.

Ask coaches how they respond to suspected concussions. Find out who evaluates an injured athlete and how parents are notified.

This network becomes especially important if an injury occurs.

Teachers may see symptoms that parents don't see at home. Parents may notice changes that aren't obvious at school. Coaches may know about a collision that happened during practice.

When those adults communicate, children benefit.

When in Doubt, Sit Them Out

This is one of the most important rules parents and coaches can remember.

If an athlete experiences a bump, blow, or jolt and a concussion is suspected, the CDC recommends removing the athlete from participation immediately. The child should not return to sports on the same day and should remain out until cleared by a healthcare provider.

There should be no pressure to "tough it out."

No game, practice, championship, or starting position is more important than a child's brain.

Returning too soon while the brain is still healing increases the chance of another concussion, and repeat concussions can have serious consequences.

Returning to School and Returning to Sports Are Different

Parents should also understand an important distinction: returning to the classroom does not necessarily mean a child is ready to return to competition.

The CDC says most children can return to school within one to two days after a concussion, often with temporary supports based on their symptoms. Returning to school can actually be an important part of recovery.

Those supports might include additional breaks, extra time for assignments or tests, reduced workload, or adjustments for sensitivity to noise and light.

Returning to sports requires a more gradual process.

The CDC recommends a six-step return-to-play progression under healthcare-provider supervision. Each step generally takes at least 24 hours, and an athlete should only advance if new symptoms do not appear.

The American Academy of Pediatrics similarly emphasizes an important principle: children are students first and athletes second. Their return to learning and normal daily activities needs to be considered before a full return to high-risk sports.

Know the Emergency Warning Signs

Some symptoms following a head injury require immediate emergency medical attention.

Parents and caregivers should seek emergency care for danger signs such as worsening headache, repeated vomiting, seizures, increasing confusion or agitation, slurred speech, weakness or numbness, decreased coordination, significant drowsiness or inability to wake, or loss of consciousness.

When you're uncertain about a possible concussion, have the child evaluated by a healthcare professional. The CDC recommends that a child with a possible concussion be seen by a healthcare provider.

Encourage Children to Speak Up

Children also need to understand that reporting an injury is not letting their team down.

Teach your child to tell a trusted adult when they hit their head or don't feel right after a collision—even if they think the injury is minor.

They should also feel comfortable speaking up if they notice that a friend or teammate seems confused, dizzy, sick, or different after a hit.

Creating that culture begins with adults.

If we tell children to speak up but then encourage them to keep playing when they're hurt, we're sending two very different messages.

Instead, we can teach them:

Your health comes first.

Brain Safety Is Child Safety

At the Children's Advocacy Centers of Cameron and Willacy Counties, we believe protecting children requires all of us.

Parents need information.

Teachers need awareness.

Coaches need to take symptoms seriously.

Children need trusted adults who will listen when they say something doesn't feel right.

As our children return to classrooms, playgrounds, practices, and playing fields across Cameron and Willacy Counties, this is an opportunity for all of us to pay closer attention.

Learn the signs

Talk to your child's teachers and coaches.

Encourage children to report injuries.

And if something doesn't look right, don't ignore it.

When in doubt, sit them out.

Because protecting a child's brain today helps protect their opportunities for tomorrow.