Dr. Moser speaks up about reporting youth sport brain injuries to the Star Ledger.
By Star-Ledger Editorial Board
If you attended a high school football games this weekend, the vision of kids dressed like armored gladiators and crashing into each other while using their helmets as missiles might have triggered a grim reality check:
We can assert with confidence that New Jersey's programs are doing what they can to limit concussions, but have we attained a firm understanding of this potential health crisis?
Yes, our schools have limited practice contact. They teach proper tackling technique. They've tightened rules to reduce helmet hits. They have the highest percentage of trainers per school in the country. They spend enormous sums on the latest helmet technology.
But when it comes to documenting brain injuries and using that data to prevent them, we are barely in the foothills, as NJ Advance Media reported Monday. There are two million sports-related concussions suffered by children under 18 every year, according to the CDC, but here in New Jersey, we don't keep track of the data to describe the rates, patterns, and trends - which is the first step toward developing evidence-based prevention of any injury. We must do better.
There is an all-sport data registry at the University of Colorado (the RIO program) that is voluntary, but not many schools from New Jersey participate. Here, we have some with their own programs, some research studies, and groups that monitor concussion frequency with grants to support that research.
But until we get data from each program, there is too much guesswork, and that is unsatisfactory when it comes to protecting the health of high school athletes.
Sen. Richard Codey, D-Essex, said he favors mandatory reporting for every school - "regardless of the sport" - and will look into it during the next legislative session, but he needs to know what he's in for.
"The problem is getting an accurate reading on the stats: We would need training and a standardized system," explains Dr. Rosemarie Scolaro Moser, a neuropsychologist from the Sports Concussion Center in Princeton, and one of the country's foremost experts on youth sports concussions. "The bottom line is funding. Many schools don't have enough trainers to cover multiple sports going on each day, so many concussions are not caught. And non-school sports have fewer regulations, so it's not uncommon for a kid to have a concussion in a rec sport and the school never knows about it."
In other words, this can't be done just by handing the trainer or student trainee an iPad and wifi access.
Dr. Jack Kripsak, president of the NJSIAA's medical advisory committee, supports mandatory reporting, but it requires more than just tracking age, sport, and absences. To document it properly, he said, "you need information on treatment, tests, doctor reports, follow-ups - it's a complexity of info that no one trainer can keep track of."
And Moser adds this caveat about the compromised confidentiality that comes with such registries: If records can be accessed, it's possible that a healthy athlete with a history of concussions might lost a scholarship opportunity.
Still, everyone agrees our state needs better accounting, coordination and effective implementation. That will take money.
We have made many strides with regard to identifying symptoms, and Kripsak reports that the players themselves have come light years in self-reporting concussions. The Institute of Medicine found self-reporting disturbingly rare as recently as 2013, when too many kidssaid "the game and the team are more important than their individual health, and that they may play through a concussion to avoid letting down their teammates, coaches, and parents."
Changing that mentality was a crucial step. But we still have an obligation to make the game as safe as it can be for our kids.