Help kids stay safe on the playground

Children run around the playground on Seymour Johnson Air Force Base, N.C. Sometimes a simple fall on the playground can lead to a concussion. The word concussion can conjure up scary connotations for parents. However, it’s important to put this mild form of TBI into perspective. (U.S. Air Force photo by Airman 1st Class John Nieves Camacho)

IN Chicago, where I grew up, recess in the winter meant rollicking snowball fights and pretend “skating” races across the school playground’s ice-covered asphalt.

One day, as I zoomed past another kid on this imaginary rink, I lost my balance, hit the ice face first and shot like a hockey puck across its slippery surface before slamming into a chain link fence.

Playground safety has improved a lot since then. For instance, sand, woodchips and wood mulch on many playgrounds have replaced the less forgiving surface that broke my fall — and my front tooth.

Still, more than 200,000 children in the United States land in emergency rooms every year from playground-related injuries, including concussions. Falls like mine are the leading cause of traumatic brain injury (TBI) among children under 14, accounting for more than half of emergency room visits that result in a TBI diagnosis.

“It’s important for parents to know that concussions don't just occur during organized sports,” said Dr. Scott C. Livingston, director of the education division at the Defense and Veterans Brain Injury Center. “Children are also susceptible while playing on the playground or participating in non-organized recreational activities.”

Recognize Symptoms

When injuries do happen, “Parents are often the first line of defense,” said Livingston. “Knowing the signs and symptoms of a concussion will help you know when it's time to seek help for your child."

Except for the damage to my tooth, my playground fall didn’t leave me with any obvious injuries other than scrapes and bruises. I didn’t have a concussion either, but my mother asked some questions that could have made all the difference: “Can you remember what happened? Does your head hurt? Are your ears ringing? Do you feel dizzy? If you feel like throwing up, please don’t do it in my car!”

Humor aside, she knew what to watch for. If I had shown symptoms, she would have taken me to the emergency room instead of the dentist.

Support Recovery

The word “concussion” can conjure up scary connotations for parents. However, it’s important to put this mild form of TBI into perspective. Although a broken tooth may seem like a lesser injury than a concussion, my tooth required a painful root canal. Years later, it needed a crown. When I smile today, no one else knows I have a fake front tooth, but I am reminded every day of that playground injury many years ago.

While every concussion is different, most children recover fully. Their resilience is one of the best things about treating children with TBIs, said Dr. Marc DiFazio, a pediatric neurologist and medical director at the Montgomery County, Maryland, outpatient center of Children's National Health System.

“Kids bounce back from even very serious head injuries,” he said. “Their resilience is inspiring.”

Understand Risks

Should parents worry? DiFazio doesn’t think so.

“We see a vast number of injuries, but the likelihood of serious head injuries is low,” DiFazio said. “The safety risks of playgrounds are relatively low compared to the health benefits of exercise, exploration and socialization.”

DiFazio believes that responsible – but not overly restrictive – supervision is the best form of prevention. Adults should know the risk of playground head injury and make sure kids play cautiously around hard, sharp or tall objects and avoid hazards like slippery surfaces. But they should encourage children to have fun while they play on age-appropriate equipment. More information about recognizing TBI signs and helping kids recover and return to school is available in the DVBIC booklet “A Parent's Guide to Returning Your Child to School After a Concussion.”

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