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Innovative Research and Advocacy
Children’s National helps coaches and young athletes, like Jerome, recognize and prevent concussions.
Meet Jerome
Eleven-year-old Jerome Thornton made a spectacular tackle during his recreational football game. As the players began to stand up and move back to the huddle, Jerome’s mom, Judy, realized he was the last one to start moving to get up. He staggered holding his helmet in his hands.
Jerome complained of blurry vision and he said he felt like he was “outside of his body.” Judy immediately called his primary care doctor’s weekend triage nurse who referred her to Children’s Emergency Department.
Jerome had a concussion or a mild traumatic brain injury (mTBI). Once considered relatively benign, concussions in children and adolescents are now recognized as serious medical problems with potentially permanent consequences. Concussions in children are often unrecognized or misdiagnosed. They do not show up in X-rays or CT scans. While some signs and symptoms are more visible (vomiting, stunned appearance) others can be more difficult to identify (e.g. changes in attention, memory, and mental speed).
Luckily, the Thorntons were referred to the SCORE (Safe Concussion Outcome, Recovery, and Education) clinic at Children’s National, the only comprehensive program in the area that specializes in mTBI and concussions with children.
Meet Jerome’s Doctor
Gerard Gioia, PhD, director of the SCORE program and chief of Children’s Division of Neuropsychology, joined Children’s in 2002, attracted by the opportunity to both see patients and conduct research. At that time, there were few tools for doctors seeing young patients with mTBI. In partnership with colleagues in Pittsburgh and with support from the CDC, Gioia is filling that need by developing a computer-based system to measure baseline neuropsychological functioning in children ages 5-18. Baseline testing has been done with professional athletes for years, but not in youth sports. A baseline test provides data about an individual’s normal state of neuropsychological function: in case of injury, the test is re-administered and compared to individual’s baseline functioning to track changes in the brain.
To that end, Dr. Gioia is a major contributing author of a Center for Disease Control and Prevention (CDC) education program called “Heads Up,” which provides toolkits about concussion management for physicians, coaches and parents. Dr. Gioia takes “Heads Up” materials on the road, speaking at hockey rinks and school parent nights to spread the word.
Dr. Gioia also started an innovative pilot program with the Brain Injury Association of Maryland to establish a formal sports concussion management system in every high school in Howard County, Maryland. There is baseline testing of student athletes, so that a family and doctor can have hard data about neurocognitive function to consult in case of injury. This information can also be used to assist the student-athlete's proper return to school, as concussions often affect the learning process. If successful, this program could be replicated statewide.
“The number one problem we see in pediatric concussion is recognition of the injury,” said Dr. Gioia. “If you can educate parents, coaches, primary care physicians, and emergency room personnel to identify it, you’re 75 percent of the way to having it solved.”
Judy was impressed by the treatment her son received. “Dr. Gioia gave me a ‘Heads Up’ kit to share with Jerome’s coach so he will be aware of the signs and symptoms of concussion,” said Judy. “Dr. Gioia was engaged and supportive. He questioned Jerome very thoroughly about how he was feeling both physically and emotionally. Afterward, Dr Gioia showed us how Jerome’s results compared to the norms,” said Judy.
Explore the Specialty Areas that Provided Jerome’s Care
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