Website helps parents, coaches recognize concussion signs in children

TORONTO -- Deciding whether a child may have sustained a concussion while engaged in play or sport can be difficult because tell-tale symptoms may not show up right away. But a new online resource aimed at parents and coaches could help make that determination a whole lot easier.

The Child & Family Research Institute at BC Children's Hospital has launched a website called the Concussion Awareness Training Tool (CATT), which flags the warning signs of concussion and explains what steps need to be taken to diagnose and manage the all-too-common brain injury.

Shelina Babul, associate director of the BC Injury Research and Prevention Unit at the hospital, spearheaded the development of the CATT website, which started last year with an online tool to help health professionals to better recognize and treat concussion.

The second phase of the site's development -- tools for parents, players and coaches -- has now gone live, and the third phase for teachers is expected to go online in the fall.

Babul, a sports injury specialist, said she had been getting calls from parents saying their child had hit their head while riding a bike or playing hockey but had been told by an emergency department doctor: "Oh, he's just had a bonk to the head. He'll be fine. Just go home."

"And those calls started getting more numerous," she said Monday from Vancouver. "And I thought there's obviously a disconnect somewhere because patients are getting the wrong information from their health-care provider. And that's a problem."

Babul and colleagues developed CATT, a free website that is updated monthly to provide the latest evidence-based research on concussion, which occurs when the brain is rapidly shaken up inside the skull following a hit to the head or a blow to the body that causes a sudden jerk of the head or neck.

The site, which has also been designed to be accessible through smartphones and other devices, provides information about concussion and tools to help parents and coaches decide how to respond to an injury, track symptoms, and to record information to show medical professionals. The site is organized into six learning modules, each of which is followed by a quick multiple-choice quiz.

CATT also includes short videos for children and teens with stories of young athletes who have had concussions and advice about safe play in contact sports like hockey, football and rugby.

"A lot of (online) tools that are out there are simple slide-decks for reading," said Babul. "We wanted to move away from that just because we were hearing, you know, 'I like to watch, I like to listen.' So we combined all that into a learning platform."

Often a when a child or teen takes a hit to the head while playing sports, they are pulled to the sidelines to be checked out but put back in the game if they don't seem to exhibit overt symptoms of concussion.

"But signs and symptoms may not appear for up to 48 hours," said Babul, putting the player at risk of a second and more serious concussion.

When a concussion is suspected, the player should be taken out of play and receive immediate medical attention to confirm the diagnosis, she said. If it is a concussion, the young person will need to rest both physically and cognitively for a period of time before being cleared to gradually return to play and learning.

"Eighty-five per cent (of concussions) resolve without long-term consequences. But if it's not managed properly, you could have long-term consequences."

That could mean persistent symptoms that can include headaches, dizziness, light and noise sensitivity, disturbed sleep, depression and poor concentration.

"I frequently say, 'Would you rather be out for two days or for two months or for two years?"' said Babul, referring to players who may balk at being sidelined so they can be medically assessed for possible concussion.

"The goal of this tool kit is to give parents and coaches quick and easy access to accurate, up-to-date information so they can be confident they're giving kids the best possible care for the best possible recovery," she said, noting that the site is funded by the B.C. Ministry of Health. "We hope it will become a resource in every home and at every sporting event in B.C., across Canada and beyond."

Dr. Paul Echlin, a sports medicine specialist and researcher who has long treated patients with concussion, said having government-supported online information "is awesome."

"It's already out there, but you can always use more," Echlin said from Burlington, Ont., where he practises. "It's non-biased, non-commercial (and) the more discussion, the more information out there, the better.

"Concussion is epidemic and it is important for government to take the public-health rein and use all the resources possible to alter the course of this (injury)."