Lately, the term “concussion” has come up with increasing regularity in discussions of youth sports. And with good reason. Professional athletes, especially those in sports such as football, have been diagnosed with long-term brain damage that is associated with multiple concussions. Parents, coaches and educators are concerned.
To help address the problem, Westchester County Executive Robert P. Astorino unveiled 10 Best Practices in a special booklet to address gaps in the way sports concussions are identified and treated, with a particular focus on reducing the risks for high school athletes.
The booklet, Safer Sports: A Collaborative Response for Westchester Sports-Related Concussions, contains the recommendations of Astorino’s Westchester Concussion Task Force. The task force, made up of local doctors, educators, coaches and trainers, all with experience in concussions, some with nationally recognized expertise, was charged with the goal of developing a model program for improving the outcomes for the full spectrum of sports-related concussions.
The booklet, which also contains information and resources related to concussions, is available online at westchestergov.com/safer-communities.
The Goal
“Concussion treatment, like all medical issues, is a complex subject. Our goal is not to scare parents, suggest we have all the answers, or to insert county government into an area where the primary responsibility rests with parents and school officials,” says Astorino. “Our goal is simply to play a helpful role.”
The Safer Sports initiative was launched after a meeting between Astorino and Mark Herceg, M.D., the county’s Mental Health Commissioner. Herceg explained that there were gaps in current concussion protocols at the high school and youth sports level. He suggested the creation of a concussion task force and Astorino agreed.
“The more resources you can bring to a problem, the better the result,” says Herceg. “Many times parents whose children sustain concussions, either in sports or otherwise, don’t know what provider to see for their symptoms. Schools and providers need to work together and that’s what we are promoting.”
Endorsed by Youngsters
Scott Cohen, a Scarsdale junior and concussion care advocate, supports the effort. Scott sustained a concussion as a freshman football player and had lingering issues. “Many of my teachers didn’t know how to handle me as a student and I had other issues that took a while to resolve,” says Cohen. “I really like this plan and feel that it would have helped me in my situation because it emphasizes a team approach, awareness, training, immediate assessments and returning to the classroom.”
Astorino says the task force will stay together and continue to explore frequency, recovery times and gender differences in concussions at the high school and youth sports level and that they would all work to encourage local schools and youth sports organizations to adopt the best practice guidelines. The 10 Best Practices have already been endorsed by the Brain Injury Association of America and New York State.
The 10 Best Practices in concussion management at the high school and youth sports level recommended by the Safer Communities initiative are:
1. START WITH AWARENESS
Formally educate parents, students, athletes, coaches, appropriate school personnel and youth sports programs about concussions and school protocols before participating in sports.
2. BUILD A TEAM
Encourage schools and youth sports organizations to have a designated concussion management team (CMT) that brings together experts trained in concussions. The team should meet or communicate regularly. At minimum, the CMT should include, but not be limited to, an athletic trainer, physician, nurse, athletic director and school/neuropsychologist.
3. REPORT WHAT YOU KNOW
Ensure that all concussions are reported along with any lasting symptoms from the field or playground, to parent, to ER, to health professional, to the classroom. Concussions do not just happen in a game; they can happen in gym class or at recess.
4. ASSESS SITUATION IMMEDIATELY
Utilize athletic trainers and conduct sideline assessments that can be compared to baseline behavior, in order to capture concussions in real time as they occur.
5. DON’T ‘ONE-STOP’ SHOP FOR ANSWERS
Districts and youth programs should provide referrals to specialists (neurologists, physical therapists, neuro-ophthalmologists, neuropsychologists), as needed, to treat specific symptoms. One provider should not be the “one-stop shop” for all symptoms.
6. UNDERSTAND THE BIG PICTURE
Ensure everyone involved understands the impact a concussion can have on behavioral, academic, emotional and physical maturation of young children.
7. STAY CURRENT
Health care providers evaluating children and adolescents must maintain a current level of understanding of the diagnosis, treatment and management of sports-related concussions.
8. ENCOURAGE TRAINING
Ensure that properly trained professionals, such as athletic trainers, are available to conduct sideline tests and that the results are reviewed and interpreted by a neuropsychologist or school psychologist.
9. BEWARE OF SIMPLE ANSWERS
Schools, youth programs, parents and students need to be aware that concussions are a clinical diagnosis, and that it takes more than a single or brief computerized test to understand the extent of the injury.
10. FOCUS ON RETURN-TO-LEARN
As important as return to play is for a child, it is more important that schools have a return to learn plan (RTL) to address issues children face as they return to the classroom after an injury. Returning to the classroom does not always parallel returning to play.
