Developmental Considerations in Pediatric Concussion Evaluation and Management

Abstract

Evaluation and management of concussion in the child and adolescent requires a developmentally appropriate clinical model, emphasizing key factors relevant to the injury manifestation and needs of the child. This chapter presents a model for clinical evaluation and management of concussion in children and adolescents at the acute and postacute stages. Multiple methods and informants are incorporated with the evaluation guided by the specific goals and timing of the service in relation to the injury. Appropriate assessment and intervention tools are discussed for each stage, as well as reasons for referral for additional levels of care. The fundamental components of a pediatric concussion evaluation include the following: definition of injury characteristics; history of premorbid and postinjury risk factors; assessment of current neurocognitive functioning, postconcussion symptoms, and balance; and examination of social–emotional functioning. Different disciplines contribute to the evaluation and management of pediatric concussion. The concept of the concussion generalist and specialist service is introduced with suggested requisite training, skills, and knowledge to evaluate and manage the full range of complexity of pediatric concussion.