My child has a concussion, Now what?
On average, kids usually recover completely from concussion within 10-14 days, but it is estimated that approximately 10-30% will have lingering symptoms. When the symptoms last longer than 4-6 weeks, this is known as post-concussive syndrome (PCS).
The concussion symptoms have lingered for a month, nothing seems to be getting better. How can I help?
A concussion causes a change from the normal routine, affecting the child emotionally, physically, and mentally. A child that was feeling well, now feels too sick to move, play, think, or enjoy recreation. The change causes a feeling of irritability, frustration, restlessness, and even a difficulty sleeping, and/or fatigue. These symptoms intertwine with the organic concussion symptoms and exacerbate the overall symptomology felt by the patient. This starts a vicious cycle of increasing concussion symptoms where worsening mood and sleep symptoms affect all other symptoms and general well being. Some kids can even become completely withdrawn from their normal life activities and routines. A critical part of recovery is to break this cycle. One method to break the cycle is to set weekly attainable goals in the form of an action plan.
How can weekly goals help?
A: Weekly goals allow the child to take control of recovery by giving the patient a task to focus on. This can reduce the depression and irritability of not being able to participate in social activities and exercise and ultimately help reduce other symptoms like anxiety and sleep disturbance.
Also, goal setting is a wonderful family opportunity to work with your child and help them choose the goal and understand the reasoning for each goal. When a child actively partakes in the setting of goals and the reasoning behind the goal, they are more likely to comply with therapy.
What is an example of a weekly goal?
A weekly goal is a new activity, that you are not currently doing, and a plan to complete the new activity. A goal is chosen from the patient education material and is designed to allow the patient to actively participate in their own recovery. A successful goal will answer these 3 questions:
- What I am going to do?
- How much I will do?
- When I will do it (what specific time of day/week)?
The goal can be in many different categories including: activity, rehabilitation, social, academic, play, nutrition, hydration, sleep goals, trigger identification and trigger avoidance.
What is an appropriate goal?
Setting the appropriate goal is a very individualized and is based on the level of recovery. You can use the patient educational material or our concussion action plan handout for guidance to create your own goal. Just remember, the goals need to be something new or challenging to expand your horizons. If you have any questions you can ask Dr. Mo and the staff at SPARCC.
How many goals should I set?
In the beginning it is encouraged to start with 3-5 goals a week. As time progresses and you are successful in achieving your action plan goals, the amount can increase from 3 goals a week up to 3 -5 goals a day.
The Take Away
Concussions change one’s daily routine and lifestyle drastically, which can lead to significant mood and depression like symptoms. Setting goals can be a way to break the cycle of these symptoms as well as intertwined physical, cognitive, and sleep symptoms. The goals allow the child to focus on the tasks and help break the rut kids can get into with post concussive syndrome when it feels like their whole lives have been flipped upside down. Piece by piece you can take control back and start to feel the reviving joy of getting back to enjoy all life has to offer.
By Troy Gustaveson and Mo Mortazavi, MD