Each year in America, an estimated 1.5 million people will suffer a traumatic brain injury, with as many as 80,000 of those experiencing long-term disability following their injury. Scott Lindgren, PhD, psychologist with University of Iowa Children's Hospital's Center for Disabilities and Development, talks about brain injuries and current treatments:
Who is most likely to sustain a head injury?
Anyone can sustain an injury at any age, but some people are at critically high risk:
- Young children are prone to injuries from falls
- Older people who have trouble getting around safely
- Teenagers are prone to sports injuries or motor vehicle accidents—especially after they've started to drive
Could you explain the range of head injuries and how the injury may affect a child's memory and function?
Injuries can range from very mild to very severe.
- In mild injuries, you might see a period of confusion that's very brief or maybe there's a headache, but problems usually go away in a few days
- In very severe injuries, the child may lose consciousness and even go into a coma for days or weeks or even longer. There can be serious problems with speaking, understanding language, walking, and memory.
In kids with a moderate to severe injury, we usually see a lot of recovery within a few months. But kids can look like they're doing just fine and still have problems paying attention, remembering, doing things quickly, trying to juggle multiple tasks, have problems in planning and self-control, things that we call executive functioning.
When we mention traumatic brain injury, we might not suspect that includes sports our children might participate in, like football or bicycling, where the child wears a helmet to prevent a head injury. What are the risks these young athletes take by returning to their sport too soon after a head injury?
Sports injuries can be a big problem, even if you wear a helmet. A helmet can provide some protection from the force of the injury, but in a major injury, the brain still bounces around and twists inside the skull.
It's really important for coaches and athletic trainers, parents and athletes themselves to take concussions seriously. We find that a lot of injured athletes return to competition too soon and this can be really dangerous. The risk of having long-term problems is much greater when an athlete has a second injury before a first injury has healed.
If a teenage athlete still has symptoms or problems like memory problems or headache or poor balance or vision problems or dizziness or things like that, they should not return to practice or competition right away. If they're having those problems, we recommend getting a medical evaluation right away.
If a traumatic-brain-injured child returns to the classroom, are there steps and provisions the child and the school need to take to make a smooth transition?
The good news is that most kids can return to school after brain injuries, so that's comforting to families and the kids themselves. However, after a severe injury, there are often problems with fatigue, memory and some of the other things that we mentioned earlier.
To help with the tendency for kids to get tired very quickly, it's often important to limit their time at school. They might return part-time for a while until they are able to handle a full school day.
There's also a need to adjust the length and type of assignments the kids have. For the memory problems, it often becomes important to provide a lot of concrete cues to help them and not overwhelm a child with too much information all at once. There may be a need to provide more one-on-one help from a teacher or a classroom associate or even a special ed teacher in order to help the child function while they're still showing some recovery from the injury.
Do you and other staff at the Center for Disabilities and Development work with schools in Iowa to help in this transition back to the classroom?
We do and we try to do that with any of the children we see through our clinics at the CDD. We also have a program put together by our staff along with the State Department of Education to help kids with brain injuries function better at school. That's a statewide program that we are available consult with any schools in the state.
We have psychologists, educational consultants, speech pathologists and other health professionals who consult with schools either meeting with parents and school staff in person or by phone or through video conferencing. We can help problem solve with schools and families to put together a workable program for the student and also to design any accommodations to help the students make progress when they get back in school.
What is the best advice you can give parents to prevent their child from sustaining a traumatic head injury?
It's really important that:
- A child wear a helmet when riding a bike or skateboarding
- Kids wear seat belts in the car
- Very young child are strapped safely in a car seat
- Children are taught safety rules when they're riding bikes or being a pedestrian
- Your home is childproofed, using gates to prevent kids from having access to stairs. For older
- Adolescents use protective head in sports
And it's critical not to take concussions lightly. Most kids recover quite well from mild concussions as long as they don't have another concussion before they're recovered from the first one. |
