A multidisciplinary, symptom-targeted approach to rehabilitation in pediatric concussion

Concussion, or mild traumatic brain injury, is a common functional brain injury with heterogeneous symptoms affecting physical, cognitive, emotional, visual, vestibular, and autonomic domains. Although most children and adolescents recover within several weeks, a substantial minority develop persistent symptoms that interfere with school participation, physical activity, and quality of life. This review summarizes principles of multidisciplinary assessment and rehabilitation for prolonged or complex concussion recovery, using the clinical model of the Multidisciplinary Concussion Clinic at Boston Children's Hospital as a practical framework. Persistent post-concussion symptoms often reflect multiple interacting impairments rather than a single unresolved process. Multidisciplinary assessment helps identify vestibular, visual, pain related, cervical, cognitive, and exertional contributors to prolonged recovery, improving patient experience and allowing more efficient, less fragmented care. Key management strategies include graded sub-symptom aerobic exercise, vestibular and oculomotor rehabilitation, treatment of post-traumatic headache and cervical pain, vision-based interventions, and individualized return-to-learn planning. Persistent post-concussion symptoms are best approached as a complex clinical problem requiring active, symptom-targeted, multidisciplinary care that can streamline recommendations and treatment planning while supporting functional recovery.