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A guide for parents & caregivers
Understanding concussion in young athletes
If your child plays sport, there's a real chance you'll face a concussion at some point. The hardest part is that a concussed child often seems fine. This guide tells you what to look for and what to do.
Why concussion in children needs to be taken seriously
A concussion is one of the most common and most misunderstood injuries in youth sport. The single biggest mistake parents make is assuming their child is fine because the child says so. Concussion does not always show up straight away, and feeling okay is not the same as being recovered.
This guide is written in plain language to give you exactly what you need: how to recognise a concussion, the red flags that mean you should seek emergency care, how to manage the first 48 hours at home, and how to safely return your child to learning and to sport
What is a concussion?
A concussion is a brain injury caused by a knock, jolt, or blow to the head, or by a force to the body that causes the brain to move suddenly inside the skull. It will not show up on an X-ray, a CT scan, or an MRI, and there is often no cut, no swelling, and no visible sign that anything has happened. That invisibility is what makes it dangerous.
The brain is not fully developed until a person’s mid-twenties. In children, the same force that causes a mild headache in an adult can cause a significantly more disruptive injury in a ten-year-old. Children’s brains are more vulnerable, take longer to recover, and are at far greater risk of serious harm if a second concussion occurs before the first one has healed.
The good news is that most children recover fully. The key is recognising it early, responding correctly, and not rushing the return to normal activity.
What are the signs and symptoms of concussion?
Concussion does not always announce itself, and your child may not lose consciousness. In fact, loss of consciousness happens in fewer than ten percent of cases. The symptoms you are more likely to notice are subtler, and they may not appear until hours after the injury, often once the child sits still and the adrenaline wears off.
Watch for any combination of the following:
Physical signs
Headache or pressure in the head, dizziness, nausea or vomiting, blurred or double vision, sensitivity to light or noise, balance problems, or feeling unusually tired.
Thinking and memory signs
Difficulty concentrating, feeling foggy or slowed down, memory gaps around the event, confusion, or trouble following a conversation.
Emotional signs
Unusual irritability, mood swings, feeling more emotional than normal, anxiety, or sadness that was not there before.
Sleep changes
Sleeping far more than usual, or struggling to fall asleep despite being exhausted.
No two concussions look the same. Some children have one or two symptoms, others have many. If your child took a knock to the head and something feels off, trust your instincts and get them assessed.
The first 48 hours: what to do at home
The first two days after a concussion are the most important, and what you do in this window has a direct effect on how quickly your child recovers. Rest is the medicine, and that means both physical rest and cognitive rest. No sport, no running around, no physical education at school, but also no screens, no reading, no gaming, and no intense social activity, because the brain needs quiet to begin healing and every demand placed on it, even watching television or scrolling a phone, slows that process down.
Your child can sleep normally once the first two to four hours after the injury have passed without any red flags developing. The advice to wake a concussed person every hour through the night is no longer current practice. If your child showed no red flags in the hours after the injury and was assessed as neurologically intact, they can sleep. Before they go to sleep, make sure you can rouse them and that they know where they are and who you are. If you cannot rouse them normally, or anything feels wrong, go to emergency.
Keep the environment calm, dim the lights if there is light sensitivity, reduce noise, and let them rest without pressure to catch up on schoolwork. Avoid anti-inflammatory medication such as ibuprofen or aspirin in the first 48 hours, as these can mask symptoms and may interfere with the brain’s natural healing response. Paracetamol is acceptable for headache, and when in doubt, call your doctor before giving anything.
Concussion red flags: when to seek emergency care
Most concussions are managed at home with rest and careful monitoring. But some symptoms indicate something more serious is happening inside the brain. If your child develops any of the following after a head injury, do not wait. Call an ambulance or go directly to your nearest emergency room.
- One pupil noticeably larger than the other
- A seizure or convulsion of any kind
- Loss of consciousness, even briefly, after appearing to recover
- A headache that is getting progressively and significantly worse
- Repeated vomiting
- Slurred speech or difficulty understanding language
- Increasing confusion or not recognising familiar people or surroundings
- Weakness or numbness developing in the arms or legs
These signs can indicate a bleed on the brain. They are rare, but they are emergencies. Every minute counts. Do not drive to the hospital yourself if symptoms are severe, call an ambulance.
Returning to learning and sport after concussion
Recovery from concussion is a process, and when it is managed well the outcomes are good. There are two parallel tracks your child needs to move through: getting back to learning, and getting back to sport. The brain needs to recover its capacity for cognitive work before it is ready for the physical demands of sport, and it is important that this sequence is respected.
Return to learn
This begins with complete cognitive rest and gradually reintroduces academic activity, starting with no school, screens, or reading, then progressing through short periods of light study at home, then part-time school with a reduced workload, and finally a full school day that is symptom-free throughout. Only when your child can manage a full school day without symptoms is their brain ready for the physical demands of sport.
Return to sport
This follows the same graduated logic, beginning with complete physical rest and moving through light aerobic activity, then sport-specific movement without contact, then non-contact training, then full-contact practice, and finally unrestricted competition. Each stage requires a minimum of 24 hours without symptoms before advancing. If symptoms return at any stage, your child stops, rests, and drops back one stage.
The most common reason children take longer to recover than they should is that someone pushed through symptoms or skipped a stage. Follow the protocol and most children are back to full participation within two to three weeks. Healthcare practitioner clearance is required before a child re-enters contact training or competition.
When to see a professional
Any child who takes a significant knock to the head during sport should be assessed by a trained healthcare practitioner, ideally on the same day or within 24 hours. If your child was removed from play for a head injury, that assessment is not optional. A practitioner trained in sports concussion will assess your child’s symptoms, cognition, balance, and neurological status, give you a baseline to measure recovery against, and make sure nothing more serious is being missed.
If symptoms are not resolving within 10 days, or are getting worse rather than better, return for a reassessment. A small number of children develop persistent symptoms beyond four weeks, which requires specialist management.
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Frequently asked questions about concussion in children
Can my child sleep after a concussion?
Yes. Once the first two to four hours have passed with no red flag symptoms, your child can sleep normally. The old advice to wake them every hour is no longer recommended. Just make sure you can rouse them and that they are oriented before they sleep.
How long does a concussion take to heal in children?
Most children recover fully within two to three weeks when the graduated return protocols are followed correctly. A small number take longer. Rushing the return to sport or school is the most common cause of a prolonged recovery.
When can my child go back to sport after a concussion?
Only after completing a graduated return to sport protocol, which begins with rest and progresses in stages, each requiring at least 24 hours symptom-free. Return to learning must come first, and healthcare practitioner clearance is required before returning to contact sport.
Can a concussion show up on a scan?
No. A concussion is a functional brain injury and does not appear on an X-ray, CT scan, or MRI. Scans are sometimes used to rule out more serious injuries such as a bleed, but a normal scan does not mean there is no concussion.
What are the danger signs after a head injury?
Seek emergency care immediately if your child has one pupil larger than the other, a seizure, loss of consciousness, a worsening headache, repeated vomiting, slurred speech, increasing confusion, or weakness or numbness in the limbs.
Do I need to see a professional for a concussion?
Yes. Any child who takes a significant knock to the head during sport should be assessed by a trained practitioner, ideally within 24 hours, especially if they were removed from play. An assessment establishes a baseline and rules out anything more serious.
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