FRIDAY, Aug. 27 (HealthDay News) -- Your child takes a hard hit during a football game. Or a nasty fall caused by a failed cheerleading stunt.

The youngster gets right back up but stumbles around a bit and seems to be only dimly aware of his or her surroundings. A worried teammate tries to converse, but you can tell from the sidelines that your child is having a hard time understanding what's being said and appears sluggish, dazed and confused.

Chances are that the child sustained a concussion. And if parents and coaches don't know how to recognize the signs and pursue prompt treatment, the child could be at increased risk for a severe brain injury, with lifelong consequences.

"If a concussion goes undiagnosed, it can increase the risk of re-injury," explained Dr. Paul Gubanich, an orthopedic specialist in the Center for Sports Health and the orthopedic surgery department at the Cleveland Clinic. "We know repeated head injuries can lead to chronic changes in the brain. Athletes who go back to play before they are fully recovered are at risk for having worse symptoms and more prolonged injuries."

A concussion occurs when the brain sloshes around inside the skull because of a blow to the head. The brain is cushioned against minor head trauma -- think a slight bump on the noggin -- by spinal fluid that surrounds it inside the skull. But a heavy impact can actually cause the brain to smack into the bone of the skull, causing bruising of the brain, torn blood vessels and nerve damage.

Because they are still developing, children and teens are more likely to have a concussion than adults, according to the U.S. Centers for Disease Control and Prevention. It also takes youngsters much longer to recuperate.

Each year, emergency rooms in the United States treat an estimated 135,000 youths 5 to 18 years old for sports- and recreation-related traumatic brain injuries, according to the CDC. Concussion causes the vast majority of those injuries.

But don't think that those concussions were all due to contact sports. Football and soccer injuries are common, but other activities associated with traumatic brain injuries include bicycling and playground activities, the CDC reports.

Even cheerleading, with its increased emphasis on wild stunts, has become a rising cause of concussion. "I've seen a lot of them getting a concussion from someone not catching them during a stunt or from a misstep taken during a tumble," said Dr. Robert Agee Jr., a sports medicine physician at Lemak Sports Medicine & Orthopedics in Birmingham, Ala., and a spokesman for the National Center for Sports Safety.

Concussions can be tough to detect. There are no outward signs of concussion, and symptoms, which sometimes appear right away, can also be delayed for days after the injury. Even doctors struggle to detect concussions because normal brain scans, including MRIs and CT scans, cannot pick them up with any degree of certainty, Agee said.

"You can't see a concussion. You can't feel it," Agee said. "You just know it from symptoms and how the person's brain is processing information."

After a child has sustained a hard blow to the head during sports or play, parents should be on the lookout for concussion symptoms. For instance, a concussion might have occurred if a child:

• Appears dazed or stunned
• Moves around clumsily and has problems staying balanced
• Answers questions slowly
• Loses consciousness, even for a moment
• Seems confused about where he or she is or what he or she is doing
• Has trouble remembering things that happened either before or after the blow
• Is behaving strangely or out of character
• Complains of a headache
• Suffers from nausea or vomiting
• Is sensitive to noise or light
• Reports blurry or double vision

Any of these signs should cause concern, expert say, and should prompt parents and coaches to seek medical attention for the child right away.

A child who's been diagnosed with a concussion needs to stay away from sports for as long as it takes the brain to heal. Research has found that a brain recovering from concussion is susceptible to increased injury if a second head injury occurs.

"The brain is already compromised by the first hit," Agee said. "Your brain is already vulnerable, and you're susceptible to having a concussion again with very minimal trauma if you go back too soon."

Brains that undergo repeated concussions are at increased risk for memory loss, cognitive problems, chronic headaches, epilepsy and eventually Alzheimer's disease, said both Gubanich and Agee.

To help protect children, make sure they wear the proper safety equipment for whatever sport they're playing. If they need a helmet, make sure it fits properly and the kids are using it as instructed. For example, if a chin strap is included, it should be worn.

Training also plays a role in concussion safety. Health experts agree that kids should learn from a coach who focuses on the fundamentals of play. As Agee said, children who know the proper stances and moves for their sport are less likely to be injured during play.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases offers a parent's guide to preventing sports injuries in children.

For more on head injury risks  , read about one teen's story.

WEDNESDAY, Aug. 25 (HealthDay News) -- Child abuse rates in the United States declined between 2007 and 2008 despite the onset of the economic recession, a new study has found.

Cases of child sexual abuse decreased 6 percent, physical abuse declined 3 percent and child neglect fell 2 percent, according to researchers at the Crimes Against Children Research Center at the University of New Hampshire.

Researchers led by center director and professor of sociology David Finkelhor said the decreases are especially noteworthy because 2008 was the first full year of the current recession and tough economic times are believed to be associated with increased family stress and child abuse.

"This is good news, but we need to be very cautious. It could be that discouragement and despair in families about their deteriorating economic situation take longer than a year to show their effects," Finkelhor said in a university news release.

However, the study did note that the recent decrease is part of a downward trend in physical and sexual abuse that's continued for more than 15 years.

"The long-term improvement for sexual and physical abuse may be related to a generation-long effort to educate and respond more effectively and aggressively to the problem," Finkelhor said. "If successful prevention efforts are behind the declines, then the improvements may persist even in the face of social stressors like the recession."

More information

The American Academy of Pediatrics has more about child abuse  .

MONDAY, Aug. 23 (HealthDay News) -- Young children raised in a household where one or both parents are aggressive or violent toward each other are more likely to be spanked, new research shows.

The study found that 65 percent of 3-year-olds were spanked at least once in the previous month, and in families that reported parental aggression toward another parent, the use of corporal punishment along with aggression or violence against another parent occurred in one out of two homes.

"The purpose of the study was to better understand patterns of common aggression and violence in families between parents and also parents' use of spanking with 3-year-olds," said study author Catherine Taylor, an assistant professor of community health sciences at Tulane University School of Public Health and Tropical Medicine.

"The children who had the highest chance of being spanked had parents who were aggressive or violent to each other, and there was a greater chance of being spanked by the victim of the partner aggression," said Taylor.

Results of the study were published online Aug. 23 and will appear in the September print issue of the journal Pediatrics.

Taylor pointed out that unlike some other studies that have been done on parental aggression and violence and the use of corporal punishment, this study focused on what some might consider more minor aggressive behaviors between parents, rather than violent domestic abuse.

"The kind of aggression we're talking about is fairly common psychological aggression and controlling behaviors -- doing things like preventing someone from seeing friends or family or withholding or taking money, or insulting and criticizing the partner," she said.

The study included nearly 2,000 families with a 3-year-old child. The families were from large cities across the United States. About 37 percent of the family members were black, about 30 percent were Hispanic and about 28 percent were white.

The mothers' education level broke down about evenly, with around 27 percent of the women having completed less than high school, another 27 percent having graduated high school and 27 percent having had some college. Almost 19 percent finished college. The average income was about $50,000, Taylor said.

The parents were married in 60 percent of the families, according to the study.

The researchers found that almost two-thirds of the 3-year-olds had been spanked at least once by one or both parents in the previous month.

In homes where both parents were aggressive or violent toward each other, the odds of a child getting spanked were doubled, the study reported.

"It's really not a surprise that if you're violent toward a partner or a partner is violent to you that you're more willing to spank your child. But what's really surprising is that something we know isn't effective with kids is still so accepted and used," said Lori Evans, a clinical assistant professor of child and adolescent psychiatry at The Child Study Center at the NYU Langone Medical Center in New York City.

"It all goes back to the old analogy that while you need a license to drive a car, nobody ever says you should take a basic parenting class before becoming a parent. It's all about prevention, and teaching parents how to cope with stress and teach alternative ways to discipline," Evans said.

Taylor added: "Parents that find themselves in relationships where there's aggressive or controlling behavior, even if it's minor, may want to seek counseling for themselves and for the good of their children. They may not realize how the stress they're experiencing can play out in how they're choosing to discipline their children."

More information

Learn more about alternative ways to discipline your children from the American Academy of Pediatrics  .

TUESDAY, Aug. 10 (HealthDay News) -- Kindergarteners may be more likely to eat vegetables if they're enticed with things such as tasting parties, cooking classes, gardening and even Popeye cartoons.

That's the finding of an eight-week study that monitored the fruit and vegetable consumption of 26 kindergarteners before and after they participated in a program that used multimedia, role models and play to promote healthy food consumption.

The research is described in the current issue of the journal Nutrition & Dietetics.

"We got the children planting vegetable seeds, taking part in fruit- and vegetable-tasting parties, cooking vegetable soup, and watching Popeye cartoons. We also sent letters to parents with tips on encouraging their kids to eat fruit and vegetables, and teachers sat with children at lunch to role model healthy eating," lead researcher Professor Chutima Sirikulchayanonta, of Mahidol University in Bangkok, said in a journal news release.

After the program, the children's vegetable intake doubled and the types of vegetables they ate increased from two to four. In addition, parents said their children talked about vegetables more often and were proud they had eaten them in their school lunch.

Among the other findings:

• Children feel special when adults sit next to them and eat the same foods.
• Involving children in food preparation helps them learn the names and colors of foods and helps develop their hand-eye coordination.

Previous research has shown that food habits and eating patterns learned in early childhood continue into later childhood and adulthood, Sirikulchayanonta said. This means that emphasizing healthy food choices at an early age can have a major impact on a person's future health, she added.

More information

The American Academy of Family Physicians offers tips for healthy children and families  .