Nav: Home

Study identifies barriers high schools face when implementing, enforcing concussion laws

November 19, 2019

All 50 U.S. states enacted concussion laws between 2009-2014 to mitigate the consequences of concussion. While details of the laws vary from state to state, all state laws address three main factors: concussion education; removal from play after suspected concussion; and return-to-play requirements.

A new study conducted by researchers at the Center for Injury Research and Policy in the Abigail Wexner Research Institute (AWRI) at Nationwide Children's Hospital investigated the barriers high schools across the country face when implementing state concussion laws.

The study, published today in Journal of Adolescent Health, found that many high schools reported challenges implementing and enforcing the three main parts of state concussion laws. Athletic trainers noted in interviews that the concussion education materials currently available often used complex medical terms, did not require active learning, and were often not available in needed languages. In addition, athletic trainers noted a lack of buy-in to state law requirements from both coaches and parents, who may not understand the potential severity of these injuries, which, in turn, made scheduling a time for this training and full compliance with school concussion policies challenging.

"Our hope is that school administrators, athletic directors, and athletic trainers can use these findings to identify implementation barriers in their own schools," said Ginger Yang, PhD, MPH, senior author of the study and principal investigator in the Center for Injury Research and Policy at Nationwide Children's. "These findings can help high schools structure their school's policies to maximize the safety of student-athletes and shed light on necessary updates and revisions to current state-level concussion laws."

The barriers to removal from play were associated with athletes' attitudes towards concussion and concussion reporting as well as their unwillingness to disclose concussion symptoms, and resistance from coaches and parents. Sports culture and "old school" mentality of parents and coaches that encourage athletes to "play through it" and "toughen up" can create an environment that is not conducive to athletes reporting symptoms. Lack of an effective system for communicating across all levels was also noted, especially when a concussion occured during an away game.

"It is imperative that parents, athletes and coaches understand and follow their school's concussion policy. It's better to sit out for a game than to get injured worse and miss the rest of the season," said Sean Rose, MD, pediatric sports neurologist and co-director of the Complex Concussion Clinic at Nationwide Children's. "Athletic directors, school administrators and athletic trainers can help create an environment that focuses on the safety of the kids and encourages the disclosure of concussion symptoms and immediate removal from play following an actual or suspected concussion."

Barriers to return-to-play centered on policy-level influences, including high costs of and limited access to medical treatment and lack of clarity or specification in state laws regarding which medical professionals can, or should, provide return-to-play clearance. The importance of athletes being treated by a medical professional with up-to-date concussion-specific medical training is desired, but access to these professionals can be disproportionally challenging for some athletes.

Policy-makers can use these findings to update current state concussion laws, clarify return-to-play language, and include ways for athletes who face sociocultural or economic barriers to be cleared to safely return-to-play. By identifying intrapersonal, interpersonal, organizational and policy-level barriers to the implementation of state concussion laws at the school level, effective implementation strategies can be developed to increase the public health impact of these laws.
-end-
More information about concussions in young athletes is available from the following resources:Data for this study were obtained from semi-structured telephone interviews with 64 high school athletic trainers whose school participated in High School Reporting Information Online during the 2014-15 and 2015-16 academic years. Data were analyzed using thematic analysis.

The Complex Concussion Clinic at Nationwide Children's Hospital is a team of specialists who work together to assess patients and develop comprehensive care plans tailored to their needs. Their unique approach to multidisciplinary care means the Complex Concussion Clinic is one-stop care when dealing with ongoing symptoms. Streamlined clinic visits involve a range of specialists, removing the need for multiple appointments and referrals. To learn more or schedule an appointment, visit https://www.nationwidechildrens.org/specialties/complex-concussion-clinic.

The Center for Injury Research and Policy (CIRP) of the Abigail Wexner Research Institute at Nationwide Children's Hospital works globally to reduce injury-related pediatric death and disabilities. With innovative research at its core, CIRP works to continually improve the scientific understanding of the epidemiology, biomechanics, prevention, acute treatment, and rehabilitation of injuries. CIRP serves as a pioneer by translating cutting edge injury research into education, policy, and advances in clinical care. For related injury prevention materials or to learn more about CIRP, visit www.injurycenter.org.

Nationwide Children's Hospital

Related Concussion Articles:

Study provides the first data on concussion risk in youth football
'These are the first biomechanical data characterizing concussion risk in kids,' said Steve Rowson, an associate professor of biomedical engineering and mechanics and the director of the Virginia Tech Helmet Lab.
Concussion alters how information is transmitted within the brain
Damage from concussion alters the way information is transmitted between the 2 halves of the brain, according to a new study.
Concussion recovery not clear cut for children
Sleep problems, fatigue and attention difficulties in the weeks after a child's concussion injury could be a sign of reduced brain function and decreased grey matter.
A concussion can cost your job -- especially if you are young and well educated
A seemingly harmless concussion can cause the loss of a job -- especially for patients who are in their thirties and for those with a higher education.
After concussion, biomarkers in the blood may help predict recovery time
A study of high school and college football players suggests that biomarkers in the blood may have potential use in identifying which players are more likely to need a longer recovery time after concussion, according to a study published in the July 3, 2019, online issue of Neurology, the medical journal of the American Academy of Neurology.
Concussion is a leading cause of injury for children in recreational sports
In a two-year study of children between ages 5-11 who play recreational sports, more suffered concussions than most any other sports-related injury.
Concussion symptoms reversed by magnetic therapy
Concussion symptoms -- such as loss of balance and ability to walk straight -- can be reversed by a new type of magnetic stimulation
Study paves way for better treatment of lingering concussion symptoms
The results of the study, released in Neuroscience journal, show that significant levels of fatigue and poorer brain function can persist for months, or even years, following concussion.
What makes athletes report or hide concussion symptoms?
Whether or not an NCAA Division I athlete is likely to report concussion symptoms depends on factors including their vested interests, their understanding of health implications, and their team culture and societal influences drawn from narratives of performance circulating in media, according to a study published May 8, 2019 in the open-access journal PLOS ONE by Steven Corman of Arizona State University, USA, and colleagues.
Kids' concussion recovery like snakes and ladders game
During the first 24 hours, home and leisure activities may be undertaken as long as they are only for five minutes at a time, and stopped if symptoms increase.
More Concussion News and Concussion Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: Reinvention
Change is hard, but it's also an opportunity to discover and reimagine what you thought you knew. From our economy, to music, to even ourselves–this hour TED speakers explore the power of reinvention. Guests include OK Go lead singer Damian Kulash Jr., former college gymnastics coach Valorie Kondos Field, Stockton Mayor Michael Tubbs, and entrepreneur Nick Hanauer.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Dispatch 6: Strange Times
Covid has disrupted the most basic routines of our days and nights. But in the middle of a conversation about how to fight the virus, we find a place impervious to the stalled plans and frenetic demands of the outside world. It's a very different kind of front line, where urgent work means moving slow, and time is marked out in tiny pre-planned steps. Then, on a walk through the woods, we consider how the tempo of our lives affects our minds and discover how the beats of biology shape our bodies. This episode was produced with help from Molly Webster and Tracie Hunte. Support Radiolab today at Radiolab.org/donate.