Following a concussion, elementary school-aged children who visit an emergency room treatment often receive inadequate treatment, according to the findings of a new study that indicates assessments are rarely given for vision and balance problems that may be experienced.
In findings published this month in the Journal of Pediatrics, researchers with the Children’s Hospital of Philadelphia indicate that adequate testing for symptoms after a concussion are received less than 45% of the time, although the children typically require those assessments during later follow up visits.
Researchers used data on more than 1,500 patients who were diagnosed with a concussion. This included electronic health record data from children ages 5 to 11 years old, who suffered a concussion from July 1, 2014, through June 30, 2015.
Of the patients seen in the ER, more than 60% of them demonstrated deficits with vision and balance, but were not given the correct assessments. Only 43% of patients who were first seen in the emergency room were given tests to assess vision and balance. However, roughly 74% of young patients would eventually receive the standardized visiovestibular assessments, or tests to assess vision and balance.
About 93% of patients who eventually sought follow up treatment from specialty doctors were given visiovestibular assessments. Nearly all young concussion patients, about 96% of patients, reported at least one somatic symptom, such as headaches or dizziness.
According to previous research, the sooner a patient is treated for concussion the more likely their recovery time will be reduced. In fact, early treatment may be the key to reducing recovery time overall.
Children ages 9 to 11 more commonly exhibited problems with vision, balance or headaches than their younger peers. Children in that age group experienced symptoms about 70% of the time while younger patients, under the age of 9, experienced symptoms about 50% of the time.
Overall, 54% of children reported experiencing problems with sleep and 66% reported problems with vision and balance.
Of those patients, 11% of children were referred for rehabilitation therapies. However, less than half of children who suffered a concussion were given letters to give to their school. Only 44% of patients were given letters that discussed school accommodations, such as taking breaks for symptoms, use of larger print books or audio books, or extra time for assignments.
In fact, 95% of patients seen in the ER were not given school instructions. In addition, 56% of patients seen in the ER were given letters allowing them to resume play, gym class, or other recreational activities.
One-third of pediatric and adolescent concussion injuries occur in elementary school age children. A recent study indicated the rates of concussion among school aged children have doubled in recent years.
More than 2 million children suffer concussions in the U.S. each year, many of those children will not receive medical attention to assess their injuries or impairments.
Children who suffer concussions are more likely to suffer emotional problems during their teen and adult years. Concussion during early years also increases a child’s risk of developing multiple sclerosis later.
“Incorporating a standardized visiovestibular assessment into practice could facilitate early targeted school accommodations and thereby improve return to learning for elementary school-aged children with concussion,” wrote study authors.