Traumatic and Acquired Brain Injury in Children

All children will have falls and injuries. Sometimes it can be hard to know if you should take care of them at home or go to see a doctor. When your child’s injury could involve their brain, the answer is to take them to see a doctor, and to keep watching them.

What Is an Acquired Brain Injury?

The most common brain injuries in children are acquired brain injuries (ABI) – meaning a child was not born with this injury, and it did not come directly from a brain illness. An acquired brain injury means that the brain is not working normally. Acquired brain injuries may be caused by strokes, heart attacks, infections with a high fever, brain tumors, or a loss of oxygen to the brain. A traumatic brain injury (TBI) is a type of acquired brain injury that may be caused by blows, jolts, or wounds.

Acquired brain injuries in children are commonly caused by:

• Falls.
• Motor vehicle crashes.
• An impact or injury.
• Assault.
• Near drownings.
• Sports injuries.

An acquired brain injury can affect:

• Thinking (memory and reasoning).
• Sensation (touch, taste, seeing, hearing, or smell).
• Language (communicating, expressing yourself, and understanding).
• Emotion and social skills (moods, personality, temper, and relationships with others).

Concussions and Mild Traumatic Brain Injuries

The term "mild brain injury" is misleading. Concussions and other mild brain injuries in children are always something to take seriously. While most children who have a concussion or other mild brain injury recover with rest, there is always a risk of brain damage and disability if they do not get proper care and follow the doctor’s treatment plan.

What Are Signs of Brain Injury in Children?

Some signs or symptoms of a brain injury might show up right away, while others might not show up for hours, days, weeks, or even months. If you suspect your child has had a brain injury, call 9-1-1 or take them to the emergency room right away. If in doubt, call 9-1-1 or ask for a doctor’s opinion.

Watch out for these symptoms. They might mean your child has a brain injury.

• Blood or clear fluid draining from nose or ears.
• Feeling weak, numb, or having tingling in arms or legs.
• Loss of consciousness or a seizure.
• Very bad headache.
• Trouble walking.
• Slurred speech.
• Double vision.
• Vomiting or nausea.
• Dizziness.
• Feeling agitated, upset, and unable to relax.
• Feeling confused.

Or if a young child:

• Will not eat or nurse.
• Will not stop crying.
• Is very drowsy or can’t be woken up.
• Is not interested in their regular toys or activities.
• Can’t do things they could do before, like using the toilet or talking. See our Developmental Milestones – Birth to Age 3 page.

Even if you don’t see any symptoms of a brain injury right away, talk to your child’s doctor if you see any of these things a few days, weeks, or months after the possible injury:

• Trouble focusing or remembering things.
• Problems in school or with grades.
• Trouble sleeping, staying asleep, or with nightmares.
• Headaches or neck pain that won't go away.
• Sensitive to light and noise.
• Not acting like themselves – changes in personality, behavior, or mood.

Preventing Brain Injuries

Here are some tips for helping your child prevent a brain injury:

• Your child should always wear helmets when playing sports, including biking, football, soccer, cheerleading, snow sports, and others.
• Check to see that your child’s coaches are following proper concussion procedures. You can find these at Head Safety Texas.
• Always have your children use seatbelts, car seats, or boosters (depending on their age and weight). Find out more on car seats on the Centers for Disease Control and Prevention’s (CDC) Road Traffic Injuries page.
• Help your children learn how to swim or sign them up for lessons.
• Install window guards and safety gates if you have young children. Find more on child safety on the Safe Kids Worldwide page on falls.
• Try to use playgrounds with soft surface areas (like gravel, mulch, sand, or rubber).

Recovery After a Brain Injury

Your child’s doctor should oversee your child’s recovery and help you know what to do. If the brain injury is less serious, simple mental rest might do it – a break from things like reading, schoolwork, video games, using a computer, or watching TV. Plus, they’ll need a physical rest from sports or other activities.

More serious (moderate to severe) brain injuries might need a few different treatments, like: medical care right away and rehabilitation in a hospital; time in a rehabilitation center; and more therapies once your child is back at home.

Recovery looks different for every brain injury and every child. Your child might need things like:

• Cognitive therapy.
• Speech or language therapy.
• Physical therapy.
• Occupational therapy.
• Neurobehavioral treatment.

You can find out more about some of these therapies on our specialty and therapy options page.

Work with your child's doctors and social worker (if your child has one) to decide what rehabilitation your child will need so that their recovery begins as soon as possible.

Returning to Activity

Your child should only go back to school and being active when their doctor has given the okay. And even then, your doctor will give you very important steps to follow.

As your child gets ready to go back, it’s very important to tell the school about their injury. Include your child as well as their doctor, teacher, and school nurse in making a plan to help your child return safely and comfortably. This team can help keep track of how the plan is going and see if it needs any changes along the way. It puts everyone on the same page to help make sure that your child is healing and healthy.

When your child gets a doctor’s okay to go back to playing a sport, it’s important to work closely with their coaches and trainers to start back carefully and gradually. The word gradually is very important – it means a slow return to activity so your child can keep healing and not get hurt more. It might mean that it will be days, weeks, or months before your child is 100% back in the action.

You can find out more by looking at the the CDC’s 5-step process for gradual return to play.

Living With Brain Injuries

No two brain injuries are alike. Some children might recover fast, and others might be working at it for years or never get back all of the skills they lost. No matter what the case, there are people and places to help your child. We have collected this list to help you get started.

• Local brain injury support groups are a chance to get help and advice from other survivors and their families.
• Texas Health and Human Services has a Comprehensive Rehabilitation Services program for people who are 15 years and older. (It might have a waiting list.)
• Texas Health and Human Services offers services to some survivors who have Medicaid or are on a waiver program. Your child or family must meet certain requirements, and there might be a waiting list. These services include:
  • Personal care – help with housekeeping, cooking, or personal care tasks like bathing and getting dressed.
  • Medical – supplies or equipment to help your child do more on their own, or maybe nursing care in your home.
  • Transportation – rides to doctor’s visits.
  • Caregiver – a break or other help for parents and caregivers.
  • Residential living – a place where your child could live and receive full-time care.

Look on our regional pages to see if there are more services and support groups in your area.