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Law to reduce concussions lacks impact

Four years after passage, legislation to minimize concussions implemented only in select schools

In recent years, sports-related concussions — especially in young athletes involved in high-impact sports — have become a topic of widespread discussion and concern. Responding to growing worries about student concussions, the Rhode Island General Assembly passed the School and Youth Programs Concussions Act in July 2010. But several years later, how well are schools actually taking measures to minimize concussion risk?

Interested in addressing this question, reserchers at the Alpert Medical School conducted a statewide assessment of high school adherance to the SYPCA. Their analysis appears in the current issue of the Journal of Trauma and Acute Care Surgery.

The law contains provisions — some of which are mandatory and others of which are only recommended — to guide school response to student concussions, the researchers noted. But because the law binds only particular schools, prevention of this injury remains difficult in some areas. Under the law, only schools that are members of the Rhode Island Interscholastic League are mandated to follow the law’s provisions, said Dina Morrissey, program coordinator for community activities at the Injury Prevention Center at Rhode Island Hospital and one of the authors of this study.

The provisions in place for schools in this league require parents and guardians to sign an information sheet about concussions. Additionally, students must be removed from play if they are suspected of having a concussion, physicians must provide clearance sheets for athletes recovering from concussions and coaches and volunteers must complete annual online concussion training.

“On our website, we have a link to current concussion information and require each athlete and parents to review state law and protocols for the injury,” wrote George Finn, athletic director for Barrington High School, in an email to The Herald.

But the researchers found there was limited compliance with both the required and recommended provisions of the law in some groups of schools.

“If you look at the Rhode Island Interscholastic League schools, they are pretty much doing all of that. But, if you look at the community league organizations, who are not bound by this law, very few give an information sheet and less than half have any requirement that volunteers be trained,” Morrissey said.

And since the Rhode Island Interscholastic League only includes high schools, middle and elementary schools are not following SYPCA guidelines, Morrissey said.

The recommended provisions for the league require school nurses to be trained in managing concussions, schools to write a “return-to-play” protocol and athletes to complete a neurocognitive test before returning to their sports.

These provisions were initially set as mandatory factors but were met with resistance due to many schools’ lack of financial ability to pay for additional training and tests, said Neha Raukar, assistant professor of emergency medicine and an author of both the SYPCA and the study.

“By (schools) not educating nurses and teachers, students could hide injuries from everyone and continue playing. But it’s hard to push recommended provisions onto schools who can’t afford certain resources, such as an athletic trainer at every game,” Raukar said.

In the coming year, the researchers hope to push for more mandatory provisions to prevent injury. Raukar said the focus for the year is to develop a statewide, standardized clearance form. “Return to learn” guidelines specifying the timeline for students who suffer from concussions to return to the classroom will be a focus, she added.



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