Conservative management of youth concussions is also necessary, in my view, in order for a program to fulfill the fundamental duty of care — a duty embodied in the United Nations' Conventions on the Rights of the Child adopted by every country in the world with the notable exception of two (Somalia and the United States) — our sports programs, like the rest of adult society, owe every child a duty of care.
Adding to the challenges sports programs face in evaluating and managing concussions, and the anxiety level of parents of children playing contact sports, is the fact that many high school programs don't employ athletic trainers who have received training in recognizing the often subtle signs of a concussion. Only 42 percent of U.S. high schools, according to the National Athletic Trainers' Association, have access to an ATC. In some states, the number is much lower (Over three-quarters of Nebraska high schools, for instance, are without ATCs).
Because physicians are present at relatively few youth sports contests and never at practices, an ATC is essential for a number of reasons.
For many-many good reasons, we should work towards the goal of having a certified athletic trainer on staff at every high school in this country.
With several recent studies demonstrating the value of neuropsychological testing in evaluating the cognitive effects of and recovery from sport-related concussions, such testing has become increasingly popular in recent years, so much so that it is now a recognized "cornerstone" of concussion evaluation, at least for "complex" concussions.
But while baseline pre-injury and post-injury testing is now ubiquitous at the professional and collegiate level and is becoming more common at the high school level as well, the cost of either conventional pen-and-paper or computerized testing, and the fact that most states require advance training and licensing to purchase and use them, have thus far restricted how widely testing has been implemented at the youth level and in rural areas where access to neuropsychologists for consultation is limited.
Funding and ways need to be found to allow for Web-based testing on a wide scale. I trust, in the coming months and years, that MomsTeam.com can become a place where every parent, can come to get the kind of testing that is currently out of the reach of the vast majority of athletes in contact sports.
A child's parent or guardian should be informed in writing if he suffers a serious injury and provide written consent before he is allowed to return to play.
In the case of concussions, parents should be provided information on post-concussion signs and symptoms, signs of deteriorating mental status to watch out for in the first 24 to 48 hours after concussion, follow-up care and return-to-play guidelines. Implementing such a rule will, by itself, prompt all of the stakeholders to take every injury to an athlete with the appropriate degree of seriousness.
