Resources for School and Sport Leaders
Creating Concussion Policy
Creating concussion management policy is critical for school and sport leaders. All concussion management policies should include the following three provisions:
- To require yearly, mandatory educational training of all coaches (paid and volunteer) in the area of current concussion management practices. This training should include up-to-date information on the identification of concussion, the signs and symptoms associated with the injury, the risks involved with allowing athletes to continue to play while symptomatic, methods of concussion assessment, and the importance of gradual return to play practices.
- To require immediate removal from play for all athletes who sustain a concussion or who exhibit signs or symptoms consistent with concussion. Any athlete who is diagnosed to have a concussion or who exhibits such signs or symptoms should be required to have written clearance from an appropriate health care provider (one who is trained in the evaluation and management of concussion) prior to being allowed to return to any physical activity.
- On a yearly basis to provide information to parents about concussion (including signs and symptoms and risks involved with continuing to play while symptomatic) and to require parents to provide written acknowledgement of such information prior to allowing their children to participate in the sport activity.
Ideally, the school/sport concussion management policy will also screen all athletes for a history of concussion during their pre-participation physical examination and administer a baseline neurocognitive assessment such as ImPACT™ or balance testing.
Pre-Participation Physical Examinations
It is imperative to recognize each athlete’s history of concussion so that those athletes at higher risk can be identified. Athletes with a history of concussion are not only at a significantly higher risk of repeated injury, they are also more susceptible to long-term effects of concussion, including post-concussion syndrome. Educational outreach to these athletes is critical.
Because previous concussions may have gone unrecognized, athletes should not only be asked about their history of diagnosed concussions, they should also be asked if they have ever experienced any of the signs and symptoms consistent with the injury. Clinical history should also detail information about other previous head, face or cervical spine injuries.
In addition to obtaining a clinical history, it is also beneficial to obtain baseline measurements that can be used for comparison purposes if and when a concussive injury occurs.Such measurements can be obtained through Graded Symptom Scale Checklists, Neurocognitive tests such as ImPACT, and the Balance Error Scoring System. Immediate assessment of concussion should include the Standardized Assessment of Concussion.
Making Academic Accommodations
Even though they may be academically strong students, concussed kids may struggle to return to normal in the classroom. Sometimeswhat they hear is comparable to what Charlie Brown heard when his teacher spoke: “Wa wa wa wa…”
Here’s some advice for making academic accommodations for student-athletes recovering from concussion:
- Recognize that academic performance may decrease while the healing process takes place. Be patient and allow the brain a chance to heal.
- Work with school counselors and encourage teachers to allow extra time for concussed athletes to complete assignments.
- Allow and encourage the athlete to take frequent breaks when studying.
- Utilize quiet environments for studying.
- Refrain from taking any significant orstandardized tests while the athlete is symptomatic.
The Value of Certified Athletic Trainers
The best-case scenario for sport coaches, administrators and parents is to have a Certified Athletic Trainer at all sport practices and games.13,25,26 Athletic Trainers are highly educated health care professionals who specialize in preventing, diagnosing, managing and rehabilitating injuries that result from physical activity. Their medical education is unique to the sport setting. Athletic Trainers possess skills that allow them to promptly and properly diagnose and manage acute and chronic injuries, including concussion. They also are qualified to make those critical decisions regarding return to play. For more information on athletic trainers, please visit the website of the National Athletic Trainers’ Association (NATA) or the Idaho Athletic Trainers’ Association (IATA).