Concussions in Kids: What Every Parent and Coach Should Know

Amir Hadanny, M.D., Ph.D.

Credit: Aviv Clinics

With National Concussion Awareness Day coming up on Sept. 19, protecting young athletes is top of mind. Concussions are one of the most common — and most underreported — injuries in youth sports. To better understand the risks, warning signs and prevention strategies, The Educated Patient spoke with Amir Hadanny, M.D., Ph.D., CEO, chief medical officer and head of research at Aviv Clinics.

Hadanny explained why kids and teens are more vulnerable than adults, how subtle signs are often overlooked, and what parents and coaches can do to help keep young athletes safe both on and off the field.

Why are kids and teens more vulnerable to concussions compared with adults?

Amir Hadanny, M.D., Ph.D.: Children and teens are uniquely vulnerable to concussions because their brains and bodies are still developing. The brain continues to prune unused connections and complete its myelination process well into the mid-20s, meaning young athletes’ nerve fibers have less insulation and protection than adults. Combine that with thinner skull bones and less developed neck muscles, and you have a brain that moves more within the skull during impact, which increases the likelihood of injury.

As a result, concussions in children can lead to longer recovery times and greater disruption of learning, mood and daily function. Because the brain is still wiring itself for the future, any injury has the potential to affect development in a way that can echo for years. That is why prevention, early recognition and careful management are so critical for this age group.

What makes concussions one of the most underreported injuries in youth sports?

AH: One of the biggest challenges we face is that concussions are among the most underreported injuries in youth sports. Many young athletes hide their symptoms because they do not want to lose playing time or feel like they are letting down their team. Some simply do not realize that the symptoms they are feeling, such as dizziness, confusion or a bad headache, are actually evidence of a brain injury.

Add to that a sports culture that celebrates toughness and playing through pain, and it becomes clear why so many concussions go unrecognized. Many youth leagues do not have full-time athletic trainers or consistent medical supervision, so unless parents and coaches are well educated and vigilant, these injuries are missed. Unfortunately, untreated or repeated concussions can have serious long-term effects, making this underreporting a major public health concern.

What are the most common — but often overlooked — signs and symptoms of a concussion in kids?

AH: The most common but often overlooked signs of a concussion in kids often go beyond the obvious headache or dizziness. Changes in mood or behavior can be an early clue. A child who becomes unusually irritable, emotional or sad after a hit may already be showing signs of brain injury. Cognitive changes are another red flag and are sometimes mistaken for normal distractions. When a child suddenly has trouble concentrating, remembering things or completing schoolwork, it should raise concern.

Physical symptoms can be subtle as well, including sensitivity to light or noise, blurry vision, or seeming more tired, foggy or slower than usual. In younger children, behavior is often the best indicator. Excessive crying, changes in sleeping or eating habits, or appearing clumsier than normal can signal a concussion even when the child cannot explain what is wrong.

A concussion does not always involve losing consciousness or dramatic symptoms, so recognizing these quieter signs is essential for early treatment and a safer recovery.

How soon after a head impact can symptoms appear, and what should parents and coaches watch for in the hours and days following?

AH: Concussion symptoms can appear right away, but sometimes they do not surface until hours or even a full day after the impact. That is why monitoring is crucial for at least 48 hours after a hit. Parents and coaches should watch for signs like headache, dizziness, nausea, imbalance, confusion, forgetfulness or mood changes. Sensitivity to light or noise, sleep problems, irritability and difficulty concentrating may show up later.

In younger children, look for behavioral clues such as unusual crying, clinginess, or changes in eating or sleeping patterns. If symptoms worsen or new ones appear, it is essential to seek medical evaluation promptly and keep the child out of play until cleared by a professional.

What steps can parents take before the season starts to help protect their child from concussions?

AH: Parents can take steps before the season even starts to help protect their children. Make sure equipment, especially helmets, fits properly, is well maintained and is worn consistently. Teach and reinforce proper technique for the sport, whether it is safe tackling in football or heading in soccer, because good form lowers the risk of injury.

Educate children to speak up if they do not feel right after a hit and check that their league follows proper concussion protocols, including having trained personnel at games and practices. New technology is also helping, with helmet and mouthguard sensors that track impact forces and alert coaches when an athlete takes a big hit so they can be evaluated right away. These tools are not a replacement for clinical assessment, but they are a valuable addition to a broader safety strategy.

With National Concussion Awareness Day approaching, what’s the single most important message you’d like parents and young athletes to remember?

AH: The most important message I want parents and athletes to remember is simple: A concussion is a brain injury, and it needs to be taken seriously every time. You cannot see a concussion on the outside, so when in doubt, get it checked out. Prompt recognition, honest reporting and proper management can protect young brains and futures and help keep sports safe and fun for everyone.