In order to develop statistics on how many U.S. children and teens are being diagnosed with concussion, the Centers for Disease Control and Prevention (CDC) analyzes emergency room data from around the country.
But, a new study finds that children’s concussions may be vastly underreported because family pediatricians, not ER doctors, are doing the examinations.
In the study, published today in the Journal of the American Medical Association Pediatrics, researchers from Children's Hospital of Philadelphia (CHOP) and the CDC used CHOP's regional pediatric network to figure out when and where children were diagnosed with a concussion.
They found approximately 82 percent had their first concussion visit at a primary care site like a pediatrician's office, 12 percent were diagnosed in an emergency department, 5 percent were diagnosed from a specialist, such as a sports medicine doctor or neurologist, and 1 percent were directly admitted to the hospital.
The authors noted that the findings indicate that many more children have suffered a concussion than recent stats suggest.
In another surprising turn, researchers found that one-third of those injured were under the age of 12. Many reports have been focused on teen athletes instead of younger children.
"We learned two really important things about pediatric concussion healthcare practices," Kristy Arbogast, lead author and Co-Scientific Director of CHOP's Center for Injury Research and Prevention, said in a statement today. "First, four in five of this diverse group of children were diagnosed at a primary care practice -- not the emergency department. Second, one-third were under age 12, and therefore represent an important part of the concussion population that is missed by existing surveillance systems that focus on high school athletes."
Alex Diamond, a pediatric sports medicine specialist at Vanderbilt University Medical Center and director of the injury prevention program, told ABC News that these findings are important to help health officials understand how prevalent concussions really are. Diamond was not involved in the study.
Pediatricians are a good choice for seeking advice and diagnosis on concussions because they know the history of the child, Diamond said.
"That’s why it’s great for a pediatrician to deal with this," Diamond said. "They know the kid at baseline and they know the family."
The findings may have far-reaching implications for what we know about the number of concussions in the U.S., the authors said, noting that this study suggests that the condition is extremely underreported if the vast majority of concussions are diagnosed outside the emergency department.
"We need surveillance that better captures concussions that occur in children and adolescents," Dr. Debra Houry, director of CDC's National Center for Injury Prevention and Control, said in a statement today. "Better estimates of the number, causes, and outcomes of concussion will allow us to more effectively prevent and treat them, which is a priority area for CDC's Injury Center."
Concussions often happen without a loss of consciousness and can have long-term effects.
In fact, a brief loss of consciousness or "blacking out" doesn't mean a concussion is any more or less serious than one where a child didn't black out.
If your child might have had a concussion, go to the emergency room or see your pediatrician if he or she has any of these symptoms:
• Loss of consciousness
• Severe headache, including a headache that gets worse
• Blurred vision
• Trouble walking
• Confusion and saying things that don't make sense
• Slurred speech
• Unresponsiveness (you're unable to wake your child)
• Ringing in the ears
Some symptoms of concussions may be immediate or delayed in onset by hours or days after injury, such as:
• Concentration and memory complaints
• Irritability and other personality changes
• Sensitivity to light and noise
• Sleep disturbances
• Psychological adjustment problems and depression
• Disorders of taste and smell
Symptoms in infants and toddlers may be more difficult to recognize because they cannot express how they feel. Nonverbal clues of a concussion might include:
• Appearing dazed
• Listlessness and tiring easily
• Irritability and crankiness
• Loss of balance and unsteady walking
• Crying excessively
• Change in eating or sleeping patterns
• Lack of interest in favorite toys
Experts recommend that parents take their child in for an evaluation if their child receives more than a light bump on the head.
Story sources: Gillian Mohney, http://abcnews.go.com/Health/concussions-children-vastly-underreported-study-finds/story?id=39506549