Concussion Bill of Rights #6: Information to Parents on Follow-Up Care and Written Consent Before Return to Play

As a recent newspaper article reported, all too often parents are not informed when their child suffers a concussion playing sports, kept in the dark about the important role they play in their child's recovery from concussion, and the all-important decision on when it is safe for their child to return to the playing field.

The sixth right of parents under the Parent's Concussion Bill of Rights is therefore the right to receive written notice of injuries suffered by their child and to provide written consent before their child is allowed to return to play. (The concussion safety laws in place in almost all states requires written approval from a concussion specialist, but not from a parent)

In the case of concussions, parents should be provided with:

• information on post-concussion signs and symptoms and signs of deteriorating mental status to watch out for in the first 24 to 48 hours after concussion (concussion laws generally mandate providing parents information on signs and symptoms but not necessarily about what to look for in terms of a serious brain injury),
• instructions on follow-up care, including the need for  cognitive rest (i.e. no homework, no school)(not yet mandated by state law), and
• the steps their child must complete, after all symptoms have cleared, in order to qualify for a return to play. (state laws require written approval from a health care provider with concussion expertise; California recently became the first state to mandate by law that athletes follow the graduated return-to-play protocol recommended by most concussion experts, and to require a minimum seven-day waiting period after a concussion before RTP is allowed).

Most of this information is contained on the Sport Concussion Assessment Tool developed by the authors of the Zurich international consensus statement on sport-related concussions.  For a pdf of the SCAT3, click here (scroll to the end to the section captioned "Concussion Injury Advice" for a very brief summary of key take-away points for parents)

Implementing these notice and written consent requirements will, by itself, prompt all of the stakeholders to take every injury to an athlete with the appropriate degree of seriousness.