title: Multimodal evaluation and management of children with concussion: using our heads and available evidence.
abstract: BACKGROUND
  Significant attention has been focused on concussions in children, but a dearth of research evidence exists supporting clinical evaluation and management.
  
  
  OBJECTIVE
  The primary objective of this review paper is to describe a multimodal, developmentally adapted, standardized concussion assessment and active rehabilitation approach for children as young as 5 years old.
  
  
  METHODS
  This study reviews the CDC-funded research programme, including the development of tools for post-concussion symptom assessment involving the child and parent, measurement of specific neurocognitive functions and assessment of dynamic cognitive exertional effects.
  
  
  RESULTS
  A clinical approach to active, individualized, moderated concussion rehabilitation management is presented, including a 10-step guide to symptom management, with a specific focus on the school challenges faced by the recovering student.
  
  
  CONCLUSIONS
  To better inform concussion practice across the developmental age spectrum, a significant need exists for further research evidence to refine clinical assessment methods and develop effective treatment approaches.
authors.affiliation: Division of Pediatric Neuropsychology, Children's National Health System, Departments of Pediatrics and Psychiatry & Behavioural Medicine, George Washington University School of Medicine , Rockville, Maryland , USA.
authors.forename: Gerard A
authors.initials: GA
authors.lastname: Gioia
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D001924:Brain Concussion / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D003131:Combined Modality Therapy; D019317:Evidence-Based Medicine; D006801:Humans; D017410:Practice Guidelines as Topic; D020127:Recovery of Function; D012572:School Health Services; D013334:Students / Q000706:statistics & numerical data*; D015599:Trauma Severity Indices; D014481:United States
keywords: Assessment; children; concussion; mild traumatic brain injury; rehabilitation