A NSW Government website


Concussion or Mild Traumatic Brain Injury (mTBI) can occur because of a fall, motor vehicle accident, contact sports or any other injury to the head. Sometimes, this can result in a loss of awareness or alertness for a few minutes up to a few hours. Some concussions are mild and brief, and symptoms may not present in the first hours after injury.

If your child receives a bump or blow to the head or body which causes a jolt of the head or neck - it is important to monitor them for signs and symptoms.

Signs and Symptoms

If your child has any of the signs or symptoms listed then they should be assessed by a doctor. It is important to note when, for how long, and how bad they are so you can tell the doctor.

Red Flag Symptoms

If you child is experiencing any of the following, please present to your closest Emergency Department for further assessments.

Concussion signs:

  • Appearing dazed or stunned
  • Repeating questions
  • Problems remembering before or after the injury
  • Confused about events
  • Showing personality or behaviour changes

Concussion symptoms:

  • Headache or “pressure” in the head
  • Dizziness and/or loss of balance
  • Feeling tired (fatigued)
  • Sensitivity to light and/or noise
  • Trouble sleeping
  • Does not “feel right”
  • Feeling more emotional, e.g. sad or nervous
  • Trouble thinking clearly, concentrating or remembering

Concussion care and recommendations

Following a concussion, rest and a gradual return to activity/school/sport is very important. Our recommended treatment includes:

We recommend 2 days of COMPLETE REST

  • No screens
  • Attempt to create a calm/quiet environment
  • Reduce cognitive load by reducing noise/light/lots of conversations
  • Naps are ok for this rest period

Then begin a gradual return to activity/School and follow the CONCUSSION ACTION PLAN

Our team will phone you to discuss your child’s recovery and provide assistance where required. This will be from a private number.
We recommend a return to normal sleep schedule as soon as possible.

Please see our website for information about


The most important treatment for a head injury is complete rest. This includes both physical and mental rest for 24-48 hours, after this your child or young person should have a gradual return to their normal activities.

During this rest period, your child or young person should not exercise, use computer screens, play video games or study. Your child may need some time away from school and sports. A gradual and staged return to school and sporting activities should be planned. The PBIRT team can help with this.

If a concussion occurs during sport or activity your child should stop playing immediately and not return until seen and cleared to do so by a doctor.

Symptom Management


Fatigue is common and needs to be managed differently depending on the stage of recovery. Initially, fatigue is managed by rest. However, once your child is starting to increase activity, it is necessary to manage this return gradually. During this graded return to normal activity, sometimes symptoms may spike briefly. This can be expected if heart rate and general activity is increased. This should gradually settle over time.

We recommend all families read this Fatigue Information sheet: Concussion_Fatigue.pdf (nsw.gov.au)


Headache is the most common symptom patients experience after a concussion/mTBI. These headaches can sometimes persist and need to be managed by the Rehab Doctor and Clinical Nurse Consultant.

We recommend all families read this Headache Information sheet: Concussion_Headache.pdf (nsw.gov.au)


After a Concussion/mild Brain Injury the sleep wake cycle can become disrupted. Initial napping during the day is important for recovery. However, when increased sleep in the day leads to later bedtimes, a disruption to the normal sleep routine occurs. Our team can recommend strategies to assist with helping sleep to go back to normal.

We recommend all families read this Information sheet on Sleep Concussion_Sleep.pdf (nsw.gov.au)


Return to Gentle Activity

After the initial rest period. It is extremely important to encourage your child or young person to gradually increase activity to help them to recover.

This link has suggestions for each age group.

Return to school

It is important to let the school know about your child’s head injury. Sometimes children who have had a head injury find it hard to concentrate in school and may have a return or worsening of symptoms such as headache or nausea. They may experience fatigue and become tired much quicker.

A graded return to school plan will ensure your child or young person is supported.

Return to Sport

It is important to inform your child’s school and sporting coach or club that they have had a head injury. Children and adolescents should not take part in school or club sports or exercise until they are completely symptom-free and cleared by a doctor.

Following a concussion, your child’s reaction times, and thinking maybe slower putting them at risk of further injury. Please speak to the team to ensure a graded return to sport has been completed prior to returning to sporting activities.

Concussion Action Plan

A concussion action plan is used to clearly identify your child’s symptoms, when to access emergency care, and gives a clear plan for rest and gradual return to normal activity.

Please see this link for more information.

Symptoms persisting?

Most patients will recover within days to weeks following injury, however, some patients will have a persistent concussion symptoms. Symptoms can include headache, dizziness, fatigue, depression, anxiety, sleep disturbance, light disturbance, forgetfulness and concentration difficulties.

The team will continue to provide management and if Persistent Concussion Syndrome is suspected, a referral to the PBIRT Concussion clinic may be recommended.

Concussion Clinic

Sometimes concussion symptoms can persist and will require medical review and assessment from other team members. The PBIRT concussion clinic helps children and young people who have experienced persistent symptoms and require further assessment and management.

The Concussion Clinic is a monthly service run by the Paediatric Rehabilitation Specialist, their Rehabilitation Registrar and the Clinical Nurse Consultant. Specialities within the PBIRT team are consulted depending on the specific needs of the patient.


621 Hunter St Newcastle West NSW 2302


For a current patient of PBIRT, referral can be made by the CNC (Clinical Nurse Consultant), Team Leader or Medical Lead.

External Referrals:

If you are a GP/ Paediatrician and would like to refer a patient to the Concussion Clinic. Please make a referral using the HNEkidsRehab Referral Form and fax to (02) 49236517

HNEkidsRehab Referral Form

Please also confirm their eligibility below.