Guest Blogger – UVA’s Donna Broshek, Ph.D. on Concussions

As part of brain injury awareness month, we have been featuring a series of articles to educate readers about how to prevent and treat concussions in children.  We were also fortunate to have Donna Broshek, who is a neuropsychologist and the Associate Director of the UVA Health System’s Brain Injury and Sports Concussion Institute, film a public service announcement with us. You can see the PSA here.  Happily, Donna also agreed to write a blog post for us.  Please join me in thanking Donna for all of her help in educating us about this important topic, and keep reading for her post:

As Bryan noted in Kids and Concussions, Part 2, Virginia passed a state law that became effective in July 2011 that requires that public schools develop a protocol for identifying and managing sports concussions, as well as providing education to students and parents.  This legislation has been very important in increasing awareness of sports concussions and keeping kids safe.  The Virginia Board of Education Guidelines For Policies on Concussions in Student-Athletes incorporated key aspects of safe management:

1)      Any athlete suspected of having a concussion should be removed from play and evaluated by a health care provider with experience in sports concussion.

2)      The student must obtain written medical clearance before being allowed to resume physical activity.

3)      Return to physical activity must occur in a gradual supervised manner – various levels of physical activity are introduced gradually while concussion symptoms are monitored.  If symptoms increase or return, the student-athlete returns to a lower level of activity until their symptoms get better.

An important issue for parents to know is that this law only applies to public schools.  Private schools are not covered, although many such schools do have good concussion policies.  Of particular importance is that private youth leagues, such as elite soccer organizations or lacrosse travel teams, are not required to have concussion policies since they are not covered by the state legislation.  It is even more important for parents to be able to recognize signs of concussion in their children and respond by seeking appropriate care when their children are not covered under the state law.

What parents can do:

1)      During the month of March, the Concussion Recognition and Response™ Coach and Parent Version phone app can be downloaded free of charge on iPhone, iPad, iTouch, and Android platforms.  The app was developed in collaboration with the Centers for Disease Control and provides step by step guidance in identifying symptoms and seeking medical evaluation.   The app also has information on monitoring symptoms at home and suggestions for school.

2)      Parents can insist that coaches of independent sports leagues develop a concussion policy that mirrors the one established by the state for public schools.

3)      Parents can lobby their legislators to fix this loophole in the state law so that any private leagues using public sports fields are required to follow the same policies as public schools.

4)      It is better to err on the side of conservative concussion management in youths as the developing brain is more vulnerable to concussions and concussion symptoms last longer in kids and teens.  If in doubt, sit them out!

Donna K. Broshek, Ph.D.

Clinical Neuropsychologist

Kids and Concussions, Part 2

Recently Donna Broshek, Associate Director of the University of Virginia Health System’s Brain Injury and Sports Concussion Institute, and I recorded a public service announcement about concussions and other traumatic brain injuries (TBI) in children. During our shoot, I was able to talk with her about this important topic.  One of the things I took away from that conversation is the importance of our role as parents in educating ourselves and our children about concussions.

Four Ways To Help Keep Your Child Safe

Bruised egos, broken bones and concussions are the biggest risks children face in sports–at an age and almost any sport. As parents we can lessen our safety concerns by becoming informed, engaged and in communication with our children, the schools and their coaches.

1)  Educate yourself.  Learn what a concussion is, its symptoms and what you can do to help your child or teen reduce the chances of a traumatic brain injury. For valuable resources see my first article, What Parents Need to Know About Concussions, Part 1.

2) Ask questions. Is your school system in compliance with the 2011 Virginia Student Athlete Protection Act? This bill established the Virginia Board of Education Guidelines For Policies on Concussions in Student-Athletes, requiring specific protocols for sports, protective gear and training.  

Talk to the coach, school administration, league representative and anyone else who is involved in your child’s sports.  How knowledgeable are they about concussions? Ask to see a copy of the school or league’s training manual for coaches and parent volunteers.

b) Check to see that helmets and equipment are up to date, in good repair and certified, if applicable.

c) Are athletes given any materials on safety, sportsmanship and injury?  Are parents given materials   on concussions?

3)  Talk to your children.  Talk about peer pressure and well-meaning adults who say, “tough it out” after an injury.  Explain in age-appropriate language what a concussion is and the dangers from returning to play too quickly. Talk from a place of love and concern about why their physical health is more important than playing when injured. Talk about the long-term effects of concussions.

4)  Get involved. Your level of involvement may depend on your child’s age. High school football players aren’t as comfortable with mom around as they were when they were children.  There are ways to become a ‘team parent’–from volunteering with fundraisers and parents’ groups to sitting on advisory committees. Attend games and practices (for younger children), show your support for the team and get to know your child’s coaches.

Your involvement as the parent of a young athlete is vital–it shows you care about your child’s participation and safety. And, should an accident occur you’re right there and able to see what happened and to take an active role in your child’s recovery from a concussion.

In my next article we’ll talk about how to prepare your child to play team sports.


Parents’ vigilance can head off kids’ concussion risk (

The CDC Parent/ Athlete Concussion Information Sheet ( ( – Helpful website for sports moms and dads.

March is Brain Injury Awareness Month!

March is Brain injury awareness month and in recognition of this the Child Safety Blog is featuring a series of articles on concussions and other traumatic brain injuries (TBI) in children.  We also did a public service announcement with Donna Broshek, who is the Associate Director of the University of Virginia Health System’s Brain Injury and Sports Concussion Institute. You can see the PSA here.

Your role as a parent is to both protect and encourage your child in the world. It’s a tough balance–you want your child to play sports and other recreational activities and you want them to be safe. By learning about concussions, the symptoms and how to prevent concussions, parents can help keep their kids safe.

According to the Centers for Disease Control and Prevention, every year over 207,000 children are treated in emergency departments for sports-related concussions and other TBIs. The highest occurrence is for youth between the ages of 5-18.

What Is a Concussion?

A concussion is a type of traumatic brain injury, or TBI, caused by a bump, blow, or jolt to the head. Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth. Excessive shaking can cause a concussion. Even a seemingly mild bump or blow to the head can be cause for concern and require medical attention.

A concussion may last for a short time or it can produce symptoms that last for days or weeks. While symptoms may appear mild, in some cases the injury can result in significant, lasting impairments.

While these should not be considered the absolute indicators of a concussion, they are signs that your child should seek medical attention:

  • Headache or neck pain
  • Nausea or vomiting
  • Ringing in ears
  • Dizziness
  • Confusion
  • Temporary loss of consciousness or forgetting the incident

For more complete details on symptoms and what you should do, see this info sheet from The Mayo Clinic. (

What To Do If You Think Your Child Has a Concussion

The first thing to do is call your child’s physician. He or she will give you advice on whether to seek immediate medical treatment or to wait and observe your child for a day or two. Some symptoms may not appear immediately so you need to pay careful attention for a number of days after the injury.

Take notes–it’s always helpful for doctors if you can provide a history of an accident. Was he hit in the head? Did she lose consciousness? For how long? Write down symptoms and any comments your child makes that may indicate signs of brain injury. For example, is your child confused about the day or time, or complaining of head pain or dizziness? The more information you can share with the doctor the better.

Try to keep your child calm during this initial period. Discourage too much physical movement and other strenuous or stressful events. Remember it’s always better to call the doctor if you’re concerned.

Some Statistics on Concussions

Children from birth to 9 years of age are most often injured during playground activities or while riding a bike.

  • The highest occurrences are in football and girl’s soccer.
  • Males represent 71.0% of all sports and recreation-related TBI visits to the emergency room.
  • Children aged 10-19 years account for 70.5% of sports and recreation-related TBI visits to the emergency room.
  • For males aged 10-19 years, sports and recreation-related TBIs occurred most often while playing football or bicycling.
  • Females aged 10-19 years sustained sports and recreation-related TBIs most often while playing soccer or basketball or bicycling.


If your child falls off his bike, bumps her head or is injured in a soccer game, he or she could suffer a concussion. Concussions can be serious if left untreated. Seek medical attention and keep a close eye on your child for the next few days–the doctor will give you suggestions on what to look for and what to do in the following days and weeks.

It’s important that you share information about the injury with teachers and coaches, if your child is in athletics, and ask them to help you watch for any potential signs of brain trauma.

And, as Donna Broshek advises in our PSA – when in doubt, sit them out.

In our next article we’ll talk about what parents can do to help prevent concussions.

Helpful Resources for Parents:

Concussions- The Kids Health Blog ( )  – Easy to read article describing concussions and the symptoms.

Concussion and Mild TBI ( The Centers for Disease Control and Prevention provides a wealth of resources on concussions.

Moms Team-Concussion Signs and Symptoms  ( Online source for youth sports parents.

Teaching Older Kids to Use Kitchen Knives Safely

I love to cook with my kids.  I was in the kitchen with one of my older girls the other day, and she asked if she could cut an onion for a soup I was making. Her technique scared me a bit, and I realized I needed to teach her how to properly use a kitchen knife.  I used to work as a sous chef for a while after college.  How well I learned to cook is debatable, but I did become pretty proficient at using a knife.  Here are a few tips:

  • Use a good, sturdy cutting board.  Keep it from slipping by using a board with non-slip feet, or put a wet towel or non-slip mat underneath.
  • Never cut food that you’re holding in your hand – place it and cut it on the cutting board..
  • Keep knives sharp – dull knives are more likely to slip and accidentally cause an injury
  • Secure the food with your opposite hand, and tuck your fingers to form a “claw” – your fingers should be straight up and down and can be used to guide the knife.  Here’s a picture of the technique.
  • Use a cutting board with plenty of space, and try to keep the tip of the knife in contact with the board as you chop.
  • Keep knives away from the edge of a counter top, and if a knife falls DO NOT try to catch it.
  • A good tool for kids to use at first is a double handled half moon knife (Mezzaluna).  This can only be used for chopping, but its design keeps stray fingers out of the way of the blade.
  • Always have adult supervision until you’re completely comfortable that a child can use a knife safely.

Here’s a good video that does a good job showing these techniques.  Stay safe and have fun cooking with your kids.

Interesting Article on Parenting

Last month, my wife and I started coming  up with a set of “Family Core Values” that we planned to use with our kids.  The idea behind them was to provide a set of bedrock, non-negotiable principles that they, and we, are expected to live by – if you are part of our family, this is what you do and how you act.  Examples include being respectful of others and yourself at all times, being grateful for what you have, rather than seeking the material things you might want, setting goals for yourself, and being persistent in reaching those goals.

In that vein, I was recently sent a very interesting article from the Wall Street Journal called Family, Inc.  It’s about running a family like a business, and among the many excellent suggestions is to develop a set of “core affirmations” that a family will do its best to live by.  I highly recommend reading the article – with our four young kids, my wife and I are constantly looking for ways to decrease stress. Obviously, many others are in the same boat, and I’m very interested in exploring effective solutions.

I’ll talk more about this later, but in the coming months I’m going to be shifting the direction of this blog somewhat.  In addition to child safety, I’m going to start writing more posts about parenting – it’s something that interests me, and, whether I like it or not, I’m immersed in it.  I’d like to share what I’m learning.  Stay tuned.

Burn Awareness Week

Every day throughout the United States, children arrive at emergency rooms for scald burn treatment. The major cause is contact with hot liquids, steam or hot foods. SafeKids USA says “90 percent of non-tap water scalds are caused during cooking or drinking hot liquids.” According to Shriners Hospitals for Children, “approximately 65 percent of children under age 4 hospitalized for burn injuries were scalded by hot liquids and 20 percent of those for contact burns.”

The majority of thermal burns to children under 14 years old are caused by contact with room heaters, ovens and ranges, clothing irons, gasoline, fireworks, hair curlers and curling irons. During the past 13 years, an average of 496 children each year died from unintentional fire or burn injury. According to the Shriners’ “Be Burn Aware” 2013 campaign, approximately 66 percent of electrical burn injuries in children ages 12 and younger are associated with household electrical cords and extension cords; and wall electrical outlet burns account for an additional 14 percent of electrical burn injuries.

Here are some tips to help avoid scald injuries to children:

  • Lower water heater temperature to 120˚F (49˚C) or less;
  • When filling a bathtub, run cold water first, then add in warmer water;
  • Before placing a child in a bathtub, check the water temperature by rapidly moving your hand through the water. If the water feels hot to an adult it is too hot for a child.
  • In the bathtub, face your child away from faucets;
  • Use knob covers on faucets; and
  • Always supervise your child closely in the bathtub.

And, to keep kids safe in the kitchen:

  • Always supervise children under age 7 using a microwave;
  • Turn pot handles on the stove inward; use oven mitts and potholders;
  • Make sure that micro waved food is thoroughly stirred before consuming;
  • Do not use deep fryers around children;
  • Do not hold children in your arms while cooking or passing hot food to others;
  • Test your baby’s food by placing one quarter spoonful on the underside of your wrist… if it’s too hot for you, it’s too hot for baby to safely swallow.

And, in case of a fire or burn emergency, Call 911 Immediately!

Kids and Guns, Part 2

Last post I wrote about the importance of keeping guns secured away from unsupervised children, and referenced a great article by the Washington State Department of Social and Health Services entitled Gun Safety.  It talks about the frightening statistics regarding kids and firearms, and also sets out the basic rules regarding safely storing and locking up guns.

It also raises an important issue that I don’t see discussed very often – the importance of teaching children the difference between fantasy play and reality.  Part of the wonder of kids is their incredible imaginations.  The bedroom of our four year old, Cate, is in a finished attic.  It’s set up like a loft, and there’s no door so you can hear everything she’s doing from the second floor.  One of my favorite things to do is simply listen to her play.   She creates these intricate characters and scenarios – truly in her own little world.  Likewise Michael, our five year old, happily spends hours playing on the floor with his cars and Lego’s.  He will also pretend to use and shoot guns – whether it be cops and robbers or some other type of game with his sisters or his friends.  We don’t forbid him from playing these games, but we have friends in our neighborhood who are staunchly opposed to guns and absolutely forbid any type of play involving guns.  It doesn’t matter – their sons still fashion sticks, pencils or whatever into pretend guns – it’s just what some kids do.

But what happens, god forbid, if an unsupervised child who’s never been exposed to a real gun comes across one.  Perhaps playing hide and seek on a play date he comes across a box in a closet.  Or opens a drawer in a bedside table. Or is able to open the gun case in the house of a parent who hunts.  This is a situation where it’s critical for a child needs to understand the difference between reality and make believe.  With a real gun, someone who is shot doesn’t come back to life like a cartoon character – the consequences are literally a matter of life or death.

So, talk to your kids about the difference between fantasy and reality – when watching TV, reading a book, or when playing with them.  As with anything you teach your kids, the concept is best reenforced with repetition – not in a way that scares or browbeats them, but so that it’s fun and challenging. Above all, make sure your kids know never to touch a real gun, and if they or their friends ever come across one they should stop, don’t touch and immediately find an adult.  No matter how you feel about guns, when it comes to unsupervised kids, this is something we can all agree on. Stay safe.

Texting and Driving – Virginia May Finally Get Tougher

My law firm, MichieHamlett, does a lot to spread the word about the dangers of texting and driving.  My colleagues Greg Webb, Kyle McNew and I have made many presentations to high schools and civic groups to educate kids and adults about the incredible risks created by distracted driving.  Research is showing that distracted driving can be more dangerous than drunk driving.

Just like it took a long time for society to respond appropriately to drinking and driving, we are finally beginning to increase penalties for texting while driving.  After many years of inadequate action, both houses of the Virginia General Assembly have finally passed legislation that makes texting while driving a primary offense (meaning that law enforcement can stop drivers based on that charge alone) and increased the fine from $20 to a meaningful $250 for first offense, $500 for second offense.  Hopefully, Governor McDonald will sign this law and Virginia will take a needed step in preventing this deadly practice.

Gun Safety and Kids

Since the horrific tragedy in Newtown, Ct, there’s been a lot of debate about whether the country needs stricter gun control measures. Many people understandably have strongly held beliefs on this subject, but there’s one aspect to this issue that we should all agree on – unsupervised children cannot be allowed to have access to guns.  The statistics regarding kids and firearm deaths are staggering, but I’m not here to take a side in the gun control/gun rights battle – I just want to keep them out of the hands of unsupervised kids.

There is lots of web content on the internet about gun safety when it comes to children, and a great, comprehensive document I’ve found is by the Washington State Department of Social and Health Services.  It’s entitled simply Gun Safety, and, if you have kids or if you own guns, I highly recommend that you read it.

A few of its initial recommendations:

  • Unload and lock up guns
  • Lock and store ammunition separately
  • Hide keys where kids can’t find them
  • Gun safe’s are best, but gun locks/trigger locks can also be effective when used correctly.

These suggestions are pretty self evident, but the article also contains helpful suggestions for how to  teach children the difference between reality and fantasy play, and also separate tips for parents who own guns and parents who don’t. In my next posts, we’ll talk further about those topics.

Accidents Due to Hazardous Children’s Furniture Should Not Happen!

On January 30, a recall was issued for 300 Natart Chelsea Three-Drawer Children’s Dressers Model 3033, by the U.S. Consumer Product Safety Commission (CPSC) in cooperation with the manufacturer, Gemme Juvenile, Inc., of Princeville, Quebec, Canada. The recall affects only 300 children’s dressers and is due to a safety hazard. The hazard: The dresser can tip over and entrap a child.

In fact, one such dresser did tip over, entrap and suffocate a two-year old toddler from Barrington, Illinois. The child attempted to climb onto an open lower drawer in order to reach the second dresser drawer, which caused the dresser to tip over on the child. The recall notice says, “When the dresser drawers are pulled all the way out and then the additional weight of a young child is applied, the dresser’s center of gravity can be altered and result in instability of the product [the dresser] and consequently tip over.”

There are so many questions–and while any conscientious manufacturer would suffer from such an experience, I ask once again, why don’t manufacturers know within a reasonable range what can happen before releasing their products to the children’s furniture marketplace? Are children’s furniture products no longer being tested for safety before being imported to the U.S.? This particular dresser, according to the CPSC notice of recall, was manufactured before the May 2009 voluntary industry standard was issued. So, one might ask why didn’t the manufacturer recall the dressers when the voluntary industry standard changed?

This is a terrible reminder to parents of young children: Accidents with young children can happen very fast and toddlers should never be left alone. Young children need supervision.

The recalled children’s dressers were sold at Furniture Kidz and juvenile specialty stores and on line by from January 2005 to December 2010 for from $600 to $900. If you have one of these, immediately stop using the dresser and remove it from your children’s access. Retrofit kits with wall anchor straps to keep the dresser from tipping are now being offered by the manufacturer for free, and consumers can contact the company by calling toll-free 1-855-364-2619 from 9 a.m. until 5 p.m. Eastern Time, Monday through Friday.

The CPSC would like everyone to know: “Every two weeks a child dies when a piece of furniture or a television falls on them.” All TVs and furniture should be anchored to prevent tipping.