The active, sports-loving teenager has suffered five serious concussions. He fell off an ATV, hit his head in a downhill skiing tumble, hit the pavement while longboarding, and recently suffered a major hit in a high school football game. Ballance went to the Calgary Childhood Complex Concussion Clinic at the Alberta Children’s Hospital to get help for his symptoms. The teenager was struggling with light sensitivity, headaches, and forgetfulness. But most of all he was struggling to fall asleep. At the clinic, Ballance met Dr. Brian Brooks, Ph.D., a concussion researcher at the Cumming School of Medicine (CSM). Brooks is a neuropsychologist who studies how to better diagnose and treat young people with concussion, and better predict recovery. His work with Dr. Lianne Tomfohr-Madsen, Ph.D., a sleep researcher at the CSM, is investigating the role of insomnia in those with poor concussion recovery. For example, they have shown that two-thirds of teens who suffer from persistent post-concussion symptoms complain of serious sleep disruption, identifying that insomnia is one of the most common side-effects of a brain injury. He and Tomfohr-Madsen, along with colleagues at UCalgary, have just completed a pilot study treating kids with insomnia after a concussion.

Published in the Journal of Head Trauma Rehabilitation, the study found that cognitive-behavioural therapy was effective in teens with post-concussive symptoms and poor sleep. The therapy is routinely recommended for people with sleep problems. But this is the first time it has been shown to help teens with concussion and insomnia. Tomfohr-Madsen, who adapted the cognitive-behavioural therapy protocol for the 24 study participants. Teens made regular visits to the clinic for one-on-one counselling for six weeks. They learned about healthy sleep habits, including removing digital devices from their bedrooms, keeping a sleep diary, challenging negative thoughts about sleep, and creating a consistent schedule by going to bed and waking around the same time every day. Although Ballance didn’t participate in the study, he is following the new protocol, and is encouraged by his results. The teen is feeling so much better, he’s returned to playing football and plans to continue playing when school resumes in the fall. Ballance’s dad says he’s seen a big change. Ballance’s mom is relieved that her son is doing better.

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Around age 5, kids should have their vision and eye alignment checked by their pediatrician or family doctor. Those who fail either test should be examined by an eye doctor. After age 5, routine screenings should be done at school and the primary doctor’s office, and if symptoms such as squinting or frequent headaches occur. Kids who wear prescription glasses or contacts should have annual checkups by an eye doctor to screen for vision changes. Watch your child for signs of poor vision or crossed eyes. If you notice any eye problems, have your child examined right away so that the problem doesn’t become permanent. If caught early, eye conditions often can be corrected. Several eye conditions can affect kids. Most are detected by a vision screening using an acuity chart during the preschool years. Amblyopia (“lazy eye”) is poor vision in an eye that may appear to be normal. Two common causes are crossed eyes and a difference in the refractive error between the two eyes.

If untreated, amblyopia can cause irreversible visual loss in the affected eye. Amblyopia is best treated as early as possible, ideally before a child is 8 years old. Strabismus is a misalignment of the eyes; they may turn in, out, up, or down. If the same eye is chronically misaligned, amblyopia may also develop in that eye. With early detection, vision can be restored by patching the properly aligned eye, which forces the misaligned one to work. Surgery or specially designed glasses also may help the eyes to align. Refractive errors mean that the shape of the eye doesn’t refract (bend) light properly, so images appear blurred. Refractive errors also can cause amblyopia. Nearsightedness is the most common refractive error in school-age children; others include farsightedness and astigmatism: Nearsightedness is poor distance vision (also called myopia), which is usually treated with glasses or contacts. Farsightedness (also called hyperopia), which is usually treated with glasses or contacts. Astigmatism is imperfect curvature of the front surface of the eye, which is usually treated with glasses if it causes blurred vision or discomfort.

Retinoblastoma is a malignant tumor that usually appears in the first 3 years of life. The affected eye or eyes may have visual loss and whiteness in the pupil. Infantile cataracts can occur in newborns. A cataract is a clouding of the eye’s lens. Congenital glaucoma in infants is a rare condition that may be inherited. It is the result of high pressure in the eye from incorrect or incomplete development of the eye drainage canals before birth and can be treated with medication and surgery. Genetic or metabolic diseases of the eye, such as inherited disorders that make a child more likely to develop retinoblastoma or cataracts, may require kids to have eye exams at an early age and regular screenings. Be sure to talk to your doctor if your child is at risk for any of these conditions. Kids of all ages — even babies — can wear glasses and contacts. Let kids pick their own frames.

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