Are You and Your Child’s School Ready for the Concussion Law?
Youth sports participation has reached an all-time high as children start sports at an early age and play them year-round. Greater participation means greater risk of contact and brain concussion. The Centers for Disease Control and Prevention estimate that there are 1.6 to 3 million sports-related concussions per year. A concussion is any alteration in consciousness due to a strong blow or motion to the head. It is a traumatic brain injury. A 2010 study published in the journal, Pediatrics, showed that 50% of all Emergency Department (ED) visits were related to concussion and that 65% occurred in youth ages 5 to 18.
In December, 2010, New Jersey became the 11th state to pass a sports concussion safety law. Now, all states and the District of Columbia have some type of youth concussion law. The New Jersey law requires all public and nonpublic schools, K-12 grades, to develop 1) an interscholastic athletic head injury safety training program, and 2) a written policy for school districts to address the prevention and treatment of sports-related head injuries.
The NJ Department of Education is required to develop an educational program on head injury for school physicians, coaches, and athletic trainers to complete. School districts are also required to distribute educational fact sheets to parents/guardians of interscholastic athletes on a yearly basis and to obtain signed acknowledgements of the receipt of these fact sheets. School districts need to have a written policy with specific procedures to be followed when a concussion is suspected. These educational programs, policies, and fact sheets will be updated on an ongoing basis to reflect the latest knowledge and standards.
Importantly, the law requires that any student, who is suspected of having sustained a concussion, must be immediately removed from athletic play and cannot return to sports until evaluated by a licensed healthcare practitioner trained in sports concussion management. Students will need written clearance from a doctor in order to return to play. This is especially important for youth who are vulnerable to Second Impact Syndrome, a rare but catastrophic immediate brain swelling that can result in death or severe neurological injury, which may occur when there is a second hit to the head before the youth has fully recovered from the first hit.
Many New Jersey Schools have gone beyond the basic requirements of this law to protect youth brains. These schools have introduced baseline neurocognitive concussion testing programs. In these programs, youth athletes take a short, computerized test that measures memory, reaction time, processing speed, and attention skills to determine how they normally function. Then, if an athlete sustains a concussion, the athlete is retested and the scores from the post-concussion test are compared to their baseline (normal) test scores. Especially for youth, a neuropsychologist or other neurocognitive specialist with expertise in understanding these tests can best interpret the differences in pre and post test scores. Test scores in addition to the results of a medical exam and physical exertional testing, such as by an athletic trainer, help to determine when the youth is recovered.
Because of cost, staffing, space, and time constraints, baseline testing is usually available on a limited basis, most often for high school varsity athletes, which leaves out much of the youth population. To address this gap, many proactive club and league youth sports teams are providing baseline testing as part of their seasonal registration process. In addition, parents and athletes may obtain testing at sports concussion
Parents should become educated about youth concussion treatment because this area of medical knowledge is developing so quickly that most health providers are not aware of the guidelines for youth, which are different from those for adults, and different from those established just a few years ago. In short, there are not enough doctors who specialize in youth sports concussion.