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Updated: Mar 18, 2026
Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion
Published on: January 20, 2019
Concussion and its management: What do parents know?
Kirstin Weerdenburg1, Suzan Schneeweiss1, Ellen Koo1
1Division of Emergency Medicine, Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario.
Insights
Parents often missed diagnosing concussions in their children, with only 40% accuracy. Increased parental education on concussion recognition and return-to-play guidelines is crucial for better child advocacy.
Area of Science:
- Pediatric Emergency Medicine
- Neurology
- Sports Medicine
Background:
- Concussion diagnosis in children presenting to emergency departments (EDs) relies on both physician assessment and parental reporting.
- Parental suspicion plays a role in identifying potential concussions, but its accuracy relative to medical professionals is not well-established.
Purpose of the Study:
- To determine the sensitivity and specificity of parental suspicion of concussion compared to pediatric emergency physicians in children with head injuries.
- To identify factors associated with parental suspicion aligning with physician diagnoses.
Main Methods:
- Parents of children aged 5–18 with non-structural head injuries presenting to an urban pediatric ED completed a 24-item questionnaire.
- Sensitivity and specificity of parental suspicion were calculated, and logistic regression was used to examine associated variables.
Main Results:
- Parental suspicion had a sensitivity of 40.0% and specificity of 58.3% for concussion.
- Children aged 10 years or older were more likely to have parental suspicion concordant with physician diagnosis (OR 3.0).
- Only 32.1% of parents were familiar with return-to-play guidelines, though most (91.5%) would stop activity if a concussion was suspected.
Conclusions:
- Parental suspicion of concussion is often lower than physician diagnosis, particularly in younger children.
- There is a significant need for enhanced parental education regarding concussion recognition and management, including return-to-play protocols.
- Improved parental awareness can empower them to advocate more effectively for their child's health after a head injury.
Objectives:
To determine the sensitivity of parental suspicion of concussion relative to paediatric emergency physicians in children who presented to an emergency department (ED) with a head injury. A secondary objective was to examine the variables associated with parental suspicion of concussion concordant with that of a physician.
Methods:
Parents of children five to 18 years of age presenting to an urban paediatric ED with a nonstructural head injury completed a 24-item questionnaire.
Results:
Of the 577 eligible parents, 495 (85.8%) consented to participate. The sensitivity of parental suspicion for concussion was 40.0% (95% CI 33.2% to 47.2%), while the specificity was 58.3% (95% CI 52.4% to 64.0%). The variable of child age ≥10 years was associated with an increased odds (OR 3.0) of a parental suspicion of concussion concordant with that of a physician; parent age, parent sex, mechanism of head injury and history of concussion in the child were not. Although 453 (91.5%) parents would stop activity if they believed their child sustained a concussion, only 159 (32.1%) were familiar with return-to-play guidelines.
Conclusions:
Parents often did not suspect a concussion when it was ultimately diagnosed by a paediatric emergency physician, although they were more likely to do so in older children. Only approximately one-third were aware of return-to-play guidelines. To enhance the potential for parent-driven advocacy in the recognition and management of concussion, these data support the need for increased parental education on this injury.
