The tool itself is an inventory of all the manifestations one might observe after a young child has suffered a concussion., summarized the neuropsychologist Miriam Beauchamp.
The tool aims to compensate for the lack of measures and tools to properly quantify and qualify the consequences in young children.
Concussions can cause cognitive symptoms, such as problems with thinking or concentrating; physical symptoms, such as trouble with balance or sleep; or behavioral symptoms, such as impulsivity, irritability or anxiety.
But a child under five will not always have the vocabulary they need to describe what they are going through or to answer questions from adults.
Professor Beauchamp and her colleagues therefore collaborated with the Emergency Department of the CHU Sainte-Justine, with parents whose child has already suffered a concussion and with other workers to compile a list of possible manifestations in children. little ones of this age.
The new tool will help measure the extent of the problem in patients who cannot explain how they are feeling.
Photo : Getty Images / freemixer
When we think of a child (0 to 6 years old), when we talk about symptoms such as headaches or loss of balance, we may wonder how he is going to tell us that he has a headache, she said. Even at 3 or 4 years old, the concept of concentration or confusion, it can be extremely difficult for a child to relate to his parents. [qu’il ne se sent pas bien]. Rarely will children of that age tell us that so clearly.
The manifestations are illustrated with concrete examples to help detect them.
A child who holds his head in his hands or rubs his forehead may have a headache. A child who gives up a drawing or a craft may have difficulty concentrating. A child who has lost weight or who refuses dessert may experience nausea.
The big challenge in this field of research and clinical practice is that at an early age, there are also behaviors that are completely normative., underlined Ms. Beauchamp.
A 2 year old who is irritable could be a perfectly healthy child.
We have to be able to decide what could be the consequence of the injury and what is not, so the tool will allow us to do that too.
Certain items, continues Ms. Beauchamp, require having observed the child in his environment. The
control List therefore, it will not be reserved for emergency care staff, but will also be for his parents or even the daycare staff he attends.
Documenting these symptoms is the cornerstone of managing and intervening to improve the consequences of concussions at any age., did she say.
But if we do not know what the symptoms are in young children, how can we provide effective management? We don’t know what they are going through, we don’t know if they are improving.
Less harmful for children?
It was traditionally believed that head trauma suffered by such young children was less damaging, since the plasticity of the brain would allow them to fully recover.
This is not entirely wrong, says Ms. Beauchamp, and children who have suffered head injuries have recovered almost miraculously,
but there is no reason to believe that an injury to the brain at an early age would be less harmful in a young child than in a school-aged child or adolescent, for example.
When we disrupt the functioning of the brain at a young age, she said, we can also disrupt the learning of language, the learning of motor skills and social skills.
Sometimes the brain, when it reorganizes, it does not reorganize optimally, she warned.
We often tend to say that the plasticity of the brain is something positive, but it can also lead to changes that deviate a bit from normal development.
Once finalized, the tool will be shared with hospitals in Canada and the United States who, in return, will share their data with researchers at CHU Sainte-Justine.
This will better quantify the prevalence of concussions in toddlers and better understand how they manifest.
And eventually, we will be able to better understand the impact at a young age, explained Ms. Beauchamp.
Is it the same as in older children? Is he worse? Is it less worse? It could also be. But without a tool like that, you can’t really come and compare the experience of young children with those of older children.
The results of this work are presented in the medical journal Journal of Head Trauma Rehabilitation.