Early multidisciplinary care accelerates recovery from trauma in children

Children recover significantly faster from concussions after receiving early, multidisciplinary care designed to treat persistent symptoms, according to a new study. And this model will provide a blueprint for future child-specific concussion clinics across Australia.

Results, published in British Journal of Sports MedicineThree months after injury, the study found that 62.5 percent of children treated with the Murdoch Children’s Research Institute (MCRI) Concussion Essential Intervention made a full recovery, compared with 37 percent who received standard care. Additionally, early intervention greatly reduced the risk of progression of physical and mental symptoms and 94 percent of children experienced improvement.

MCRI researcher Vanessa Rousa said the findings address a major gap in brain care for children whose symptoms do not resolve quickly.

“Most children recover after a concussion, but about one-third continue to experience symptoms that disrupt school, play, and everyday life,” he said. “This study shows that if we identify those children early and provide targeted, coordinated care, we can significantly speed recovery.”

Former Victorian Minister Danny Pearson visited MCRI last April to announce the launch of a study that will explore the impact of this intervention in a dedicated children’s concussion clinic. This study is supported by a Victorian Medical Research Acceleration Fund (VMRAF) grant.

The randomized clinical trial involved 158 children aged eight to 18 with ongoing post-injury symptoms who were recruited from the emergency department of the Royal Children’s Hospital (RCH) and GP referral within a few weeks of their head injury. Treatment began four weeks after injury and treatment was delivered weekly for eight weeks by an integrated multidisciplinary team, with their care adjusted as symptoms developed.

The study, led by MCRI in partnership with the Neurological Rehabilitation Group, found that participants who received tailored care combined with education, physiotherapy and psychological support were significantly more likely to make a full recovery than those who received usual care alone. The program was feasible and acceptable to families, despite the commitment required to complete treatment.

Children in the intervention arm experienced significantly less sleep and less severe symptoms, and improvements in their physical, cognitive and mental health.

Concussions are one of the most common reasons children come to the hospital for head injuries. While most recover within a few weeks, about 30 percent continue to have symptoms. Current care often focuses on a single treatment or involves delays between referrals, which may worsen symptoms.

MCRI Professor Vicki Anderson SIncorporating this intervention into routine clinical practice will support supported outcomes.

“Concussions are a growing health concern, the diagnosis and management of which are poorly understood,” he said. “Children do not experience trauma in the same way. By bringing together education, physiotherapy and psychological care and tailoring treatment to each child, we can respond to those different needs. We believe that early targeted treatment can also reduce the need for repeated health care visits and specialist referrals.”

Professor Anderson said further research would focus on how the model could be expanded beyond the hospital setting.

“We now need to look at how this kind of care can be scaled up to community clinics and delivered through options like telehealth so that more families outside metropolitan areas can access effective treatment,” she said.

Macy, 15, was injured during a surfing lesson during a school trip last year.

After getting off his surfboard, Massey rubbed his head on the ocean floor, causing a sand burn above his right eyebrow.

Mum Jo said Maisie seemed fine at first, but after 18 hours it became clear something wasn’t right.

“Macy wasn’t like that at all,” she said. “She was listless, emotional, tired and easily overwhelmed, she had headaches and kept bumping into things. Three days after her wipeout, Maisie was back at school, but she was overwhelmed by all the noise in the classroom, couldn’t follow what the teacher was saying and ended up leaving in tears. I woke her up early and made a GP appointment that day.”

A GP diagnosed Messi with concussion and when his symptoms did not improve, he was referred to a sports doctor and physiotherapist.

But the turning point came when the family came to know about a news about MCRI’s new concussion clinic.

Joe said, “It was wonderful that we found the clinic, a relief and a blessing.” “There was hope that Maisie could recover and receive all the specialist care she needed in one place.”

Joe said the clinic was a turning point in Macy’s recovery.

“We didn’t have to convince the clinic staff of anything, they understood immediately,” he said. “Macy ultimately got the practical support she needed, and the team liaised with her school and recommended tailored adjustments. This helped teachers understand what Macy was going through and made it easier for her to return to learning.”

Joe said Macy gradually improved while attending eight sessions at the clinic.

“It took her about five months to recover, leaving her depressed and frightened at times,” he said. “But the girl who came into the clinic and the girl who came out were completely different.”

To help identify concussions early, the Concussion Essentials (HeadCheck) app has been designed by MCRI’s leading pediatric concussion experts in collaboration with the Australian Football League. The free assessment tool educates parents, coaches and players to understand when therapy is needed and how to safely manage recovery.

Researchers from the University of Melbourne, the University of Queensland, Austin Hospital, Cabrini Hospital, the University of Canterbury in New Zealand, Deakin University and Monash University also contributed to the study.