All of the recent consensus statements on sport-related concussions recommend a more conservative approach to concussion management for the youth athlete than for older athletes:

1. The National Athletic Trainers' Association 2004 Position Statement: Management of Sport-Related Concussion¹ recommends that "special consideration must be given to the young athlete," that perhaps they should be restricted from further participation on the day of injury, and that "additional consideration should be given as to when to return these individuals to activity" based on the fact that:

• The brain of the young athlete is still developing and the effects of concussion on the developing brain not yet completely understood

• Even subtle damage can lead to learning deficits adversely affecting development

• Age-related differences exist between high school and collegiate athletes in terms of rate of recovery, with slower resolution of self-reported symptoms for the former.

• Concussed high school athletes demonstrated prolonged memory dysfunction, and performed significantly worse on select memory tests than age-matched control subjects at 7 days post-injury compared to college athletes in a 2003 study.

• Sport-related head injury has a relatively high incidence rate and is a significant public health concern in youth athletes in general, not just participants at higher competitive levels.






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2. The Summary and Agreement Statement of the 2nd International Conference on Concussion in Sport, Prague 2004² recommends, on the basis of the "different physiological response during childhood to head trauma" that a "conservative return to play approach" be followed for athletes under age 18 under which it "may be appropriate to extend the amount of time of asymptomatic rest and/or length of the graded exertion in children and adolescents." The statement also introduced the concept of "cognitive rest" with "special reference to a child's need to limit exertion with activities of daily living and to limit scholastic activities while symptomatic."

3. The American College of Sports Medicine's 2006 Consensus Statement on Concussion (Mild Traumatic Brain Injury) and the Team Physician³ recognizes age as a factor in return-to-play decisions because "the developing brain may react differently to trauma than [a] mature brain."

4. International Conference on Concussion in Sport, St. Moritz 2006. According to Dr. Robert Cantu the consensus statement that is expected to be issued as a result of the 3rd International Conference on Concussion in Sport held in St. Moritz in 2006 may vary significantly from the Prague statement in its recommendations for management of concussions in children.

Author: Lindsay Barton
Date created April 5, 2008
© 2008 MomsTeam.com, Inc.

1. Guskiewicz, Kevin, et al. "National Athletic Trainers' Association Position Statement: Management of Sport-Related Concussion," Journal of Athletic Training, 2004; 39(3): 280-297.
2. The 2nd International conference on concussion in sport held in Prague in 2004
3. American College of Sports Medicine's 2006 Consensus Statement on Concussion (Mild Traumatic Brain Injury) and the Team Physician.

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