A lesson in concussionOne of your honor roll students fails a test in your class. You review the student’s recent work and see that there is a decline as if his attitude has shifted. Now that you think of it, this student has been daydreaming in class too. What’s going on? Did something happen at home? Does a student suddenly become lazy? Or is there more to it than that?

For most educators, the possibility that this student may have a concussion is not the first explanation that comes to mind. But it is a very real possibility.

A concussion is a brain injury. Brain injury can severely impact a student’s academic performance and can also change behavior. Brain injury is unique to each individual who sustains one and recovery varies from days to years. Cognitive consequences can include memory loss, slowed ability to process information, trouble concentrating, organizational problems, poor judgment, and difficulty initiating activities. Physical consequences can include seizures, muscle spasticity, fatigue, headaches and balance problems. Emotional/behavioral consequences can include depression, mood swings, and anxiety.

The Brain Injury Association of New Jersey (BIANJ) has been actively working to protect New Jersey’s young athletes from the dangers of concussion since 2005. That’s when BIANJ assembled a group of dedicated professionals working in fields related to concussion treatment and education and formed the Concussion in Youth Sports Committee.

The committee developed a plan that included a consensus statement to define concussion and its features. They recruited endorsements for the cause (NJEA was among the first supporters) and held a summit where parents, coaches, and other concerned parties could discuss the challenges associated with concussion and raising awareness of its effects.

The summit, held at Giants Stadium in February 2006, was a huge success. The work of raising awareness began. The Association’s website (www.sportsconcussion.com) was created, posters were designed and printed, fact sheets were distributed, and BIANJ rolled out a grant program to introduce 100 New Jersey High Schools to computerized baseline testing software.

The culmination of all the energy and work came in December 2010 when A-2743 was signed into law. The law mandates that:

“A student who participates in an interscholastic sports program and who sustains or is suspected of having sustained a concussion or other head injury while engaged in a sports competition or practice shall be immediately removed from the sports competition or practice. A student-athlete who is removed from competition or practice shall not participate in further sports activity until he is evaluated by a physician or other licensed healthcare provider trained in the evaluation and management of concussions, and receives written clearance from a physician trained in the evaluation and management of concussions to return to competition or practice.”

Components of the law

Highlights of the law include:

  • The creation of an athletic head injury safety training program.
  • Development of an educational fact sheet that student-athletes and their parent(s) must sign.
  • A model policy on concussion applicable to grades kindergarten through 12 that will be developed by the N.J. Department of Education.
  • Each school district must develop a written policy concerning the prevention and treatment of sports-related concussions and other head injuries among student-athletes.

With the new law and focus of attention on sports concussion, it is inevitable that teachers and administrators will need training on concussion and concussion policy. Some of the issues that need to be clarified are computerized baseline testing, diagnosing and preventing concussions, qualified professionals who treat concussions, return to play criteria, and academic accommodations.

Here are some key facts for teachers and administrators:

1.      Computerized baseline testing is only one of the tools available for clinicians to use to make sound return-to-play decisions. Clinicians also monitor recovery with information provided by teachers, coaches, and athletic trainers when deciding if it is safe to return to play.

2.      CT and MRI scans do not identify concussions. A concussion can only be diagnosed by a clinician who can interpret the signs and symptoms of concussion as provided by the athlete, the coach, athletic trainer, classroom teachers, parents, team peers, and friends of the athlete. Any of these individuals may have important information that can aid recovery from concussion. At this time there is no technology that can diagnose a concussion.

3.      Helmets do not prevent concussions. Helmets prevent skull fractures. When a body is in motion and suddenly stops the skull stops but the brain continues to move at the speed prior to the stop. The brain moving inside of the skull is what causes the concussion. This same phenomenon occurs in a car crash but at a much higher speed and which can result in a much more severe injury.

4.      Concussions do not only happen on the playing field. Students have many activities beyond the school day. When signs and symptoms of concussion are apparent a student may have sustained a concussion from an out of school activity; however, the same school accommodations can aid recovery and prevent a subsequent concussion.

5.      A neuropsychologist is a psychologist who specializes in brain/behavior relationships. This specialist is often brought into the treatment plan when a concussion is taking more than two or three weeks to resolve.

Teachers and school administrators play a key role in identifying concussions and helping facilitate students’ recovery. It is important for them to be well informed and aware that they very well might come across a student with a concussion/brain injury. The Brain Injury Association of New Jersey is available and eager to help in such cases. For more information you can visit the BIANJ website at www.bianj.org or call 800-669-4323.

Joanna Boyd is the public education coordinator for the Brain Injury Association of New Jersey, which is located in North Brunswick, N.J. She can be reached at jboyd@bianj.org.