Parents will know that the program and the coach take concussions seriously if the coach has met with parents and athletes before the start of every season to educate them about the dangers of concussions.
Parents will know the program and the coach take concussions seriously if the meeting includes a presentation by a medical physician familiar with the grading and evaluation of concussions and return to play guidelines; a doctor who can educate parents on the important role they play in their child's recovery from a suspected concussion, especially in terms of checking for signs of deteriorating mental status requiring immediate hospitalization, ensuring that their child gets the cognitive rest required, and monitoring for continuing concussion signs or symptoms that should absolutely rule out a return to play and may indicate the presence of post-concussion syndrome.
Parents will know that a program takes concussions seriously if it has brought in former athletes from the school to share personal stories about the consequences of continuing to play with concussion symptoms or after a series of concussions, to tell them about their reoccurring headaches, their depression, and their memory problems.
Parents will know that a program takes concussions seriously if it brings in members of their peer group — parents of concussed athletes like me — to emphasize how critical it is that, in making the all-important return-to-play decision, they consider not the here and now, but the entire life cycle of their child: if I let her play now, what will her life be like in ten, twenty, thirty years? Will she be suffering from chronic, major depression, or Alzheimer's?
Parents will know that a coach takes concussions seriously if they hear the coach at the preseason safety meeting actively encourage athletes not only to self-report post-concussion symptoms, but to inform the coaching staff or athletic trainer about teammates with symptoms if they fail to report them to the staff.
Parents will know that the coach takes concussions seriously if he tells them that if they self-report their symptoms, they will not jeopardize their place on the team, but also that, if they don't play by the rules, if they don't report symptoms — their own or a fellow player's — if they lie about them when asked, if they try to fudge their answers on baseline neuropsychological tests, if they say they are symptom-free so that they can be cleared to play in the next game, they will be suspended or kicked off the team entirely for violating team rules.
Parents will know that the coach and the program takes concussions seriously if they enforce strict penalties for any lacrosse, ice or field hockey player who strikes a blow to another players head in a game or practice.
Parents will know that the coach and the program takes concussions seriously if they know that the athletic director or administrator, the coach, the athletic trainer (if there is one), and the team doctor have, at the very least, agreed upon and adopted a philosophy for grading and managing concussions before the start of the season and use it consistently during the season, regardless of the athlete or circumstances surrounding the injury. In other words, that no double standard when it comes to concussions will be applied — one for regular players, another, more lenient, standard for the "stars."
The sad fact, and what makes it sometimes hard for parents to truly believe that programs are taking concussions seriously, is that many of the sports programs in which their children participate do not follow any set of return-to-play guidelines, and many clinicians believe that the current return-to-play guidelines are too conservative. When parents are kept in the dark like that, when they have no clue as to how a program treats concussions, their anxiety level naturally goes up. This happened to me when my son Taylor sustained a soccer concussion and his AT told him he only needed to sit out one day.
Some advocate against any rule that would flat out bar players who experience concussion signs or symptoms from returning to the same game or practice. They view such a rule as not only unworkable but counter-productive. Their fear is that such a strict, unyielding rule is likely to be evaded by the very players it is designed to protect, leading players to simply stop telling sideline medical personnel that they have any symptoms so as to avoid being benched for the remainder of the game. Many parents, either out of ignorance of the risks or out of a desire to see their child achieve athletic success, adhere to this view as well.
Others, myself included, believe that the rule that best protects our children, is the easiest to apply and the one best supported by the available science, is that reflected in the consensus statement of the 2nd International Conference on Concussion in Sport held in Prague in 2004: a rule that recommends no return to play for concussed athletes in the same game regardless of how quickly the symptoms appear — to clear.
