More kids are getting concussions younger

by Rita Giordano

Published May 31, 2016, 11:15 a.m. ET

Are we underestimating how many children get concussions?

And is it happening to more children at younger ages than previously thought?

Yes to both, according to a new joint study by the Children's Hospital of Philadelphia (CHOP) and the U,S. Centers for Disease Control and Prevention.

The study, which was published online Tuesday in JAMA Pediatrics, found that the majority — four out of five — of over 8,000 concussion diagnoses within the CHOP network over a four-year period were made at a primary care practice rather than at a hospital emergency department.

That, said leader author Kristy Arbogast, co-scientific director of the hospital's Center for Injury Research and Prevention, "is exactly the opposite" of what had been previously thought, based on data collected on emergency visits and high school and college athletics.

In addition, more of the diagnosed patients in the study were younger than had been expected: one-third were under 12.

"This study provides direction for healthcare networks and clinicians about the critical importance of providing targeted training and resources in primary care settings," Christina Master, a coauthor and CHOP pediatric sports medicine specialist, said in a statement.

CHOP has offered widespread training on concussions to doctors in its network in recent years, Arbogast said.

Diagnosing young children can be different than older children.

For example, Arbogast said, instead of asking about nausea or difficulty concentrating in school, as one would of an older child, primary physicians - made aware of the great likelihood of concussion than past data suggested - can tailor their questions to younger patients when head injury is suspected.

Young children might instead be asked if their head or tummy hurts, or their vision might be tested.

The CHOP/CDC study covered up to age 17. Eight-two percent of the children had their first visit about a concussion at a primary care site, 12 percent at an emergency department and five percent in specialty care such as sports medicine. One percent were directly admitted to the hospital.