Concussions in children are alarmingly frequent, affecting over a million children in the U.S. each year. An estimated 50% of all concussions are undetected, unreported, and untreated.
As the founder and director of a concussion clinic in New York, I see my fair share of concerned parents who want to do everything they can to help their kids heal from concussion. It’s a good instinct: Early and active intervention with targeted therapies is critical. From years of caring for children and adolescents with concussion, my team and I wondered if the parents most involved in their children’s recovery—some might call them “helicopter parents”—could be a key part of navigating a serious medical problem which, left untreated, may have devastating consequences.
Our society has turned against helicopter parents, viewing them as unnecessarily controlling. But they are uniquely valuable as a temporary framework for healing. The treatment regimen for concussion involves drastic lifestyle changes surrounding their daily screen-time exposure, shifting circadian rhythms, intellectual stimulation, and the cognitive demands of school or work. Everything has to be turned down or dialed back, sometimes for weeks at a time. The brain heals gradually, and each lifestyle change removes a source of strain it would otherwise have to contend with while heeding a vigilant dietary and sleep schedule.
I see often in my clinic that the children with very involved parents are the ones most likely to recover swiftly and without complications. After their child gets a concussion, these are the parents who diligently and methodically plan waking hours, sleeping hours, meal times, recreation, and exercise, and gradually adjust screen time. These strict parental accommodations are fundamental to recovery.
Although the degree of supervision may be controversial to developmentally favored ideas of nurturing independence in adolescence, a brief “helicopter” approach in the context of youth brain injury can be remarkably effective. Parents of young children or young adults who are recovering from concussion must be involved from the start and commit to executing all aspects of the recovery plan while modeling positive coping styles.
These interventions can also be effective for young adults in their 20s who had already adjusted to and embraced an independent life. One typical reaction of a parent to their twenty-something offspring could reasonably be that their child has to navigate their treatment and recovery on their own.
Yet irrespective of their age or how long they had or had not lived at home, my team and I found, time and again, that it’s extremely beneficial to have a parent swoop in, micromanage a patient’s schedule, and deliberately revert to the past concern and meticulous care that they took on when their child was very young. The person they are caring for who has to adhere to the concussion regimen cannot easily follow the regimen without them.
A young woman was hit in the back of her head in a boating accident, and suffered an “out of body” experience. Her father reluctantly traveled from far to come to her side, believing she was a young adult who could surely manage this invisible injury by herself. He found her to be different: she had confusion when calculating tips, struggled with maps, and complained of headaches in her entire head accompanied by eye pain. After a few days together, she reluctantly pulled out of the marathon she had signed up for and allowed her father to regulate her protein intake and remind her when it was her bedtime.
Another young man was skiing and fell forward down a hill, landing 30 feet downhill. Every time he looked at a screen, “it was the shape of a lightbulb, surrounded by tiny little pinwheels” and said “my mental compass was off and I could hear my internal monologue.” Here began the necessary dialogue with his family and his mother was soon at his side, ensuring that he took the correct vitamins at the correct time, cutting tablets into half when doses needed to be titrated, and counting his eye and neck exercises.
No matter how motivated a concussed individual is to achieve recovery, they rarely have the capacity to follow the treatment regimen, which involves drastic lifestyle changes affecting their daily screen exposure, shifting circadian rhythms, intellectual stimulation, and the cognitive demands of school or work. The intriguing and undeniable result was a patient who recovered more swiftly and with fewer complications or setbacks when compared with their independent counterparts. The helicopter parent actively reinforces the details, effectively guiding an incremental and purposeful exposure to stimuli. The parent also validates the recovery process as an active coach, facilitating and motivating the path ahead.
Concussion recovery is best accomplished using a systematic and methodical approach. Each advancement toward complete recovery is closely calibrated whether it be bedtime, the number of minutes of breaks between screen exposure, or even the heart rate at which the first cardiovascular exercise is attempted. A helicopter parent can be taught and also encouraged by their child’s doctor to maintain strict sleep and waking schedules, specific protein-based meals, drastically reduce screen time, supervising exercise, and with a constant willingness to adjust specific circumstances of exposure to monitor recovery.
The goal of medicine is to heal, and we found that healing is best accomplished by a clear adoption of the helicopter approach, albeit for a transient period.
We often triumphantly declare the last visit to a concussion clinic as graduation. It marks a return to normal activities: sports, homework, time spent with friends. Their commencement to self-governance has begun.
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