Prevent TBI in Children Through Education, Safety Measures

The Michigan Alliance for Families defines traumatic brain injury (TBI) as an injury developing from experiencing a sudden head trauma that injures the brain. It can affect how someone thinks, feels and functions for the rest of his or her life. 

According to the Brain Injury Association of Michigan, over 58,000 people in Michigan will be affiliated with a TBI every year, and many of those victims will be children. TBI is the leading reason for disability and death for children, according to the Centers for Disease Control and Prevention, with ages from birth to 4 and ages 15 to 19 being at the greatest risk.

“The top causes of TBI in children are falls, abuse, motor vehicle accidents and being struck by an object,” said Dr. Gregory Gafni-Pappas, a board-certified emergency physician at St. Joseph Mercy Ann Arbor Hospital and member of the Michigan College of Emergency Physicians Board of Directors.

Statistics report that about two out of every five instances of a TBI in children are related to some type of sports participation. The top 10 sports TBIs in children have been associated with cycling, football, baseball and softball, basketball, skateboards or scooters, water sports, trampolines, soccer, winter sports and powered recreational vehicles.

Educating parents and school staff such as teachers, coaches and administrators can work to mitigate TBI incidents in children. As part of that initiative, Michigan was the 39th state to approve a measure regulating concussions from sports injuries. The law was initially passed June 30, 2013 and was further amended in October 2017. 

The Michigan Sports Concussion Law requires all coaches as well as anyone else involved with youth athletic activities involving children to take a concussion-awareness training class at least once every three years. Additionally, it requires the Michigan Department of Health and Human Services to review its concussion-awareness training materials and program periodically.

It also states the organizing entity must give educational information regarding the signs and symptoms of TBI to all athletes, parents and guardians, and get back a signed acknowledgment that they were received. Plus, any athlete who suffers a TBI or is suspected of suffering one must be pulled from the game or activity and must get a doctor’s permission to return.

When it comes to identifying TBI in children, there are several signs and symptoms, including acting dazed, being listless or tired, irritability, balance problems, no interest in normal activities, sleep issues, memory problems, psychological issues, taste and smell changes and sensitivity to light.

TBI in children is sometimes hard to diagnose, but one way TBIs are diagnosed is via a computed tomography (CT) imaging scan. However, according to studies reported in medical literature, radiation from a CT scan is known to increase the lifetime risk for radiation-associated cancer, such as leukemia, brain tumors and thyroid cancer. 

Millions of children get CTs every year, but research has shown that CT scans could be avoided for children deemed at low risk of TBI who come to the emergency room with a suspected head injury or concussion.

The Michigan College of Emergency Physicians has received a chapter grant aimed at reducing CTs on children coming to the emergency room with minor head trauma. The grant funds a new awareness program called Mind MI Head.

“The goal of our campaign is to protect children from unnecessary radiation risks, provide education to both parents and the physician community within the state of Michigan regarding the appropriate use of head CT scans in children, and decrease resource utilization, thereby ultimately lowering total cost of care,” said Gafni-Pappas. “Our goal is to educate parents, families and physicians in Michigan regarding when CT imaging of the head is and is not indicated.

“The Mind MI Head campaign will soon be spread via brochures, posters, radio broadcast advertisements and online via social media,” he added. “We hope that this information will enable informed discussions and shared decision making between providers and parents in regard to the best care for their children.”

Parents can also lessen the chances of children incurring a TBI by doing things like using safety gates to keep small children safe from falls on stairs, not letting children climb on furniture, using guards to prevent children from falling out windows, using car seats and seat belts, using helmets when riding bikes or scooters, as well as during things like skating, skiing and snowboarding.

There are also several online training courses to help Michigan educators, coaches and parents to learn more about TBI in children. Tohose free courses include:

Four modules of TBI courses at mitbitraining.org: Traumatic Brain Injury and Public Services in Michigan, Pediatric TBI, Cognitive and Behavior Consequences of TBI in Adults, and TBI and Substance Abuse. Free continuing-education credits can be earned by taking the modules.

There is also a 10-page booklet available to answer common questions regarding TBI titled “A Guide for Patients and Their Families,” available for download at michigan.gov/documents/mdch/TBI_Recovery_Guide_10.8.08_252053_7.pdf.

To help educate high school coaches about TBI in regard to sports injuries, the National Federation of State High School Associations and the Centers for Disease Control and Prevention also offer a free online training program at nfhslearn.com/courses/61129/concussion-in-sports.

Another free online training course geared to helping parents and school coaches keep children safer from TBI is HEADS UP Concussion in Youth Sports, available at headsup.cdc.gov.

The bottom line is that parents, coaches, teachers, administrators and medical personnel must all work together to help predict, prevent and recognize TBI in children. Doing that will help lower the incidents of thousands of Michigan youth ending up in the emergency room with a possible TBI or concussion injury.

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