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Pediatric Post-Concussion Program at Mary Free Bed

Management of concussion injury in children and teens presents unique challenges related to developmental and physiologic characteristics. Programs designed for adults do not adequately address these developmental characteristics. Recognizing the unique needs of children and teens, Mary Free Bed developed the Pediatric Post-Concussion Program to provide optimal care for injured youth recovering from concussion.

Pediatric rehabilitation program at Mary Free Bed Rehabilitation Hospital. What is a Concussion?

A concussion injury results from a forceful blow to the head and neck. This can cause a disruption in brain metabolism and injury to the muscles of the head and neck producing a range of symptoms affecting thinking, emotional well-being, and physical comfort. Concussion injury is considered a traumatic brain injury. A concussion can occur in sports, car accidents, falls, bike accidents, or physical assault, including child abuse.


It can be difficult to know if your child has sustained a concussion. When children play sports, the style of play can sometimes be pretty rough. Accidents happen − kids bump heads, run into each other, fall. Signs you should look for in your child following a blow to the head are:

  • Appears dazed
  • Is confused about activity or play preceding the hit
  • Moves clumsily
  • Answers questions slowly
  • Personality or behavior changes
  • Difficulty remembering activity leading up to or right after the hit
  • Loss of consciousness

Unfortunately, medical tests such as CT scans and MRI scans of the brain often show no hard evidence of this kind of injury to the brain. But, that doesn’t mean the brain wasn’t injured. The metabolic system of the brain can be disrupted by this sort of injury and may require several weeks to recover. And, even if your child doesn’t lose consciousness, it’s still possible for him or her to have a concussion or mild brain injury, which can cause a cluster of cognitive, emotional, and physical symptoms.


Following concussion, a child may exhibit cognitive, emotional, and physical symptoms. An injured child may not have all of these symptoms, but rather experience a combination of symptoms, including:

Physical symptoms

  • Headache
  • Nausea or vomiting
  • Feeling dizzy
  • Excessive sleepiness or being harder to wake than usual
  • Fatigue or weakness
  • Complaints about blurred or double vision or other changes in eye movement
  • Hypersensitivity to sound and light
  • Ringing in the ears or difficulty hearing
  • Difficulty with balance that you didn’t notice before 

Cognitive symptoms

  • Changes in memory (losing details, forgetting to do things)
  • Confusion
  • Mental fatigue
  • Changes in performance at school
  • New difficulty concentrating or staying with a task
  • Having trouble finding the words to express him or herself or talking much more than is characteristic
  • Change in personality

Emotional symptoms

  • Irritability
  • Depression
  • Anxiety
  • Change in personality 

Symptoms aren’t always evident right away. It’s common after being seen in the emergency room to be sent home with instructions to monitor for onset of any of the above symptoms. Symptoms may last for days, weeks, or longer. A good rule to follow is to report any changes in your child’s behavior. Evaluation by a children’s rehabilitation specialist may be indicated – especially if the symptoms last longer than three or four days.

Returning to School and Other Activities

It’s generally safe to have your child slowly return to normal activities, including school, as long as you monitor closely for symptoms. It’s a good idea to alert the teacher that your child has sustained a blow to the head, and that you’re monitoring for any changes in the way he or she behaves or performs at school. If the teacher notices changes or symptoms described above, it may be appropriate to involve specialists to evaluate the impact of these symptoms on the child’s ability to learn and to identify ways to best help your child function successfully in school.

Returning to Physical Activity and Sports

Close collaboration with your physician before and during return to physical activity and sports is very important.

Return to sports play is determined by several factors, including:

  • Grade or severity of the concussion
  • Whether the patient has had any previous concussions
  • Whether a sufficient period of time without any symptoms at rest or with exertion has been achieved
  • Nature of the activity
  • Whether symptoms return once the activity is resumed

After being symptom free, a graduated progression of activity is recommended while continually monitoring closely for return of any symptoms. If symptoms return, activity must be reduced again. 



According to The Journal of the American Medical Association, two or more concussion injuries during contact sports can affect an athlete’s thinking and learning abilities for years to come. After you have had one concussion injury, every subsequent concussion injury puts you at risk for more severe problems.

Learn More About

Pediatric Concussion
Sports Concussion

Contact the Pediatric Post-Concussion Program

For more information or to make a referral, please contact the Pediatric Post-Concussion Program at:

616.242.0353 or 800.790.8040

Outpatient Referral Form

Pediatric Post-Concussion Patient Stories

Camden sustained a concussion while snowboarding. Read Camden's story...

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