Norwalk is First in Connecticut to Approve Concussion Program for All Youth Sports

Norwalk has become the  first community in Connecticut to approve a city-wide concussion program for all youth sports, according to city officials.  The Norwalk Common Council, on the recommendation of its Recreation & Parks Committee, approved the new concussion guidelines this week, modeled after The Concussion Aware and Prepared Program (CAPP). Officials said the guidelines will apply to organized youth sports programs using Norwalk recreation facilities. The guidelines are intended to “plug the loophole that exists” in the current Connecticut Concussion Law which protects only public middle and high school athletes who play for school-sponsored teams, officials said.

“It is important that our children are protected and that parents and coaches have the information they need to keep them safe,” said Norwalk Mayor Harry Rilling. “Norwalk is proud to be a leader in providing these updated guidelines for all leagues who play on our public fields. We aim to make youth sports as safe as possible."

Last month, Connecticut’s Task Force on Youth Athletics and Concussions, staffed by the State Commission on Children, reported the results of their mandated study of  "occurrences of concussions in youth athletics” and issued recommendations for possible legislative initiatives.  The 21-member Task Force noted that “there exists within the State of Connecticut the need for guidelines in the arena of non-scholastic youth athletics,” indicating that private clubs and public recreation teams are examples of “non-scholastic” youth athletics.

The Norwalk Guidelines apply to any youth up to age 19 who participates in any organized sporting or athletic event or activity either conducted by the City of Norwalk or permitted to take place on any property or facility owned by the City of Norwalk. Activities including practices, training, performances, scrimmage, games and other organized competitions involving athletic activities such as sports and dance. With a population of just over 85,000, Norwalk is Connecticut’s sixth largest city, and has the third largest population in Fairfield County.

Former Norwalk Junior Lacrosse and RCA Soccer Coach, Katherine Snedaker, now Executive Director of the non-profit, PinkConcussions.com , and advocacy organization Sports CAPP.com which developed The Concussion Aware & Prepared Program, said, “our mission with these new guidelines is to help youth sports leagues update their policies with best practices, and increase safety for our kids while lowering personal liability for our coaches and city.”  The Concussion Aware and Prepared Program, which uses free online materials from the United States Centers for Disease Control and Prevention (CDC), is designed to provide up-to-date information regarding concussions for youth coaches and their staffs, parents and youth players and is available in English and Spanish.

“Hopefully this program will be a model for the rest of state,’’ Snedaker said. “Parents will now know their young children will have some of the same protections that benefit public middle and high school athletes.”  In Norwalk, the newly approved guidelines had received support for the Norwalk Youth Football and Cheer, Norwalk Junior Soccer Association, Norwalk Cal Ripkin Baseball, Norwalk Little League and Norwalk Junior Lacrosse, according to the SportsCAPP website.

The Sports CAPP program recommends five components that should be included in every concussion program. They are:

• Pre-Season Education and Training for coaches, parents and players to be able to recognize signs and symptoms of a concussion.
• Plan for Athlete’s Removal from Play for a suspected concussion by coach or athletic trainer or parent
• Communicating with Parents and Healthcare Providers after an injury
• Plan for Return-to-Play for the player who is 100% symptom free, has been cleared in writing by an MD, and has returned to a full academic schedule at school
• Injury Reporting and Data Collection for all occurrences of concussions at the end of each sport season, or such other date as may be mandated by the principal, sports team president or other leader.

The new guidelines for school programs in Connecticut approved by the State Board of Education (SBE) in January, will go into effect July 1, 2015, requiring that:

• Prior to taking part in athletic activities high school athletes and their parents or guardians will be required to read materials, watch videos, or attend in-person training regarding the school district’s concussion plan.
• Parents and guardians must sign an informed consent form that includes a summary of the district’s concussion plan.
• Coaches must complete training to recognize the signs and symptoms of concussions and learn how to get appropriate medical treatment for students.

The new State Department of Education “Concussion Education Plan and Guidelines for Connecticut Schools” indicates that “concussions can cause a wide range of functional short- or long-term changes affecting thinking (memory and reasoning); sensation (touch, taste and smell); language (communication , expression and understanding); or emotions (depression, anxiety, personality changes, aggression, acting out, and social inappropriateness).”  It points out that “athletes should rest their bodies and brains until they are no longer experiencing any symptoms of concussion.  Physical and cognitive exertion, such as homework, playing video games, texting, using a computer or watching TV may worsen symptoms.”

Under the state guidelines for schools, coaches must immediately remove any student participating in athletic activity who exhibits symptoms or behaviors consistent with a concussion or who is diagnosed with a concussion. Parents or legal guardians must be notified as soon as possible and no later than 24 hours after such removal. Before a student can return to any team activities, a licensed health care professional trained in evaluating concussions must provide written clearance.

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Concussion Education Plan Due to School Districts on January 1; Advisory Panel Meets Today

Three weeks from now, Connecticut should have in place a state concussion education plan to be used by local and regional boards of education.  That’s according to a law passed by state legislators earlier this year in response to growing concerns about the potential lifelong effects of concussions on students injured in school sports. Local school boards will be responsible for implementing the plan using written materials, online training or videos, or in-person training.

The Connecticut Youth Concussion Advisory Group, coordinating the state’s effort, has met four times this fall.  Minutes of the most recent meeting, on November 6, were posted to the group’s website more than a month later, just days ahead of the meeting scheduled for Thursday, December 11.  That meeting is to include an update on the Concussion Education Plan, according to the meeting agenda.

Although the law was approved in May, it was highlighted in public ceremonies in September in Westport, the hometown of three mothers who were instrumental in advocating for passage of the law. Each of their sons’ lives were changed by concussions. Ann Sherwood, Pippa Bell Ader and Diana Coyne came together to form the Parents Concussion Coalition, FOX Connecticut reported.

Public Act 14-66 requires the state Department of Education to consult with the state Department of Public Health, the governing authority for intramural and interscholastic athletics, an appropriate organization representing licensed athletic trainers, and an organization representing county medical associations to do the following:

• By January 1, 2015, develop a concussion education plan to be used by local and regional boards of education. Boards of education will be responsible for implementing such plan using written materials, online training or videos, or in person training.
• Develop a signed informed consent, which must include a summary of the concussion education plan, and a summary of the local board’s policies regarding concussions. For the school year beginning July 1, 2105, local boards of education must prohibit a student athlete from participating in intramural or interscholastic athletic activities unless the student athlete and a parent or guardian returns such form.
• Collect and report to DPH all occurrences of concussions, including the nature and extent of the concussion and the circumstances in which the student sustained the concussion.

The law also requires that a training course regarding concussions be developed or approved, and that “a refresher course regarding concussions, including current best practices, and, for football coaches, current best practices around the frequency of games and full contact practices and scrimmages.”  That provision was effective on October 1. 

At the November meeting of the Advisory Group, “there was discussion regarding the pros and cons of mandating a specific time frame between stages of recovery from a concussion versus considering each case individually and relying on the student’s physician,” the meeting minutes reported.  Among materials reviewed were a Concussion Web page, Concussion Education Initiative Course feedback, and an annual review and refresher course.

Regarding data collection, the Advisory Group “discussed what will work best for schools; what is an ideal versus realistic approach.”

The Connecticut Interscholastic Athletic Conference (CIAC) Board of Control is requiring all CIAC member schools (including private and parochial schools not covered by the law) to develop a plan and begin implementation in the 2014-15 school year.

Westport’s Staples High School is among the Connecticut school that now provide concussion protocols on their websites, so that students, parents, coaches and the community are aware of expected practices.  According to the Staples site, “links include concussion education, the concussion care plan that is to be filled out by your physician when a concussion occurs, our procedures for concussion management, and our Return to Play protocol that will be followed by all athletes before returning to competition after sustaining a concussion.”

Connecticut was one of the first states in the nation to adopt a concussion law, in 2010, following Oregon and Washington, which implemented similar statutes in 2009.  The law dealt primarily with training requirements for coaches.

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Concern Over Concussions Changes Playoff, Practice Plans in CT High School Football

Concern over concussions is impacting the high school football playoff calendar, and the practice regimen throughout the season.  The Connecticut Interscholastic Athletic Conference has voted to increase to one week the minimum time between playoff games a high school team can play.  Previously, high school football games could play two games in less than a week, at times with as little as three days between games.  In making the revisions, which eliminated a quarter-final round next season, the CIAC indicated it would “continue to evaluate possibilities for changes to the regular season and postseason schedule for the 2015 season and beyond.”

In addition, the organization’s Sports Medicine Committee approved policy changes that cut back on “permitted allotment of person-to-person contact time in practice” and are “intended to limit live action,” including:

• Prior to the start of the regular season a coach may conduct person-to-person contact drills up to 120 minutes during practice plus conduct one full scrimmage or seven-on-seven scrimmage per week under game-like conditions.  If a second scrimmage is conducted the time (60 minutes) must be deducted from the 120 minutes allowed.
• From the start of the regular season through Thanksgiving a coach may conduct person-to-person contact drills up to 90 minutes per week.
• During the post season a coach may conduct person-to-person contact drills up to 60 minutes per week.

The Hartford Courant reported that “for the first time, there will be limitations on contact drills in practice throughout the season.”

Guidelines on the Web

The CIAC website includes an 8-page document developed  by the National Federation of State High School Associations, “A Parent’s Guide to Concussion,” which includes the admonition  (in bold type) “when in doubt, sit them out!”.  The policy was revised and approved in April 2013. CIAC is a member of NFHS, which also offers a free on-line course on the subject for coaches and administrators.

The guidelines indicate that “following a concussion, many student-athletes will have difficulty in school.  These problems may last from days to months…”   The guidelines also explain that “At this time we do not know the long-term effects of concussions (or even the frequent sub-concussive impacts) which happen during high school athletics.”

The CIAC website includes a link to the “Sports Medicine & Concussion” information under two drop-down menu categories on the organization’s website: “CIAC for Students & Parents” and “CIAC for Administrators. “  It is not listed among the “CIAC for Coaches” links.

Regarding the schedule changes, Ledyard head coach Jim Buonocore, who serves on the committee that approved the revisions, told the New London Day, "You had teams playing three games in 10 days, which is not healthy." The Day reported that quarterfinal and semifinal games were played the Tuesday and Saturday after Thanksgiving because the playoffs had to be completed in two weeks. The CIAC didn't want to extend the season another week due to weather concerns, and because it would further interfere with winter sports.

The CIAC has changed its high school football playoff format in 2010, and intends to revisit the issue, balancing the traditional Thanksgiving conclusion of the regular season with the health interests of students on teams reaching the playoffs, the realities of New England winters, and the academic and school sports calendars.

Additional information about concussions and high school sports is available from the Centers for Disease Control and Prevention.

Concussions in NFL, Youth Sports Earn Attention from Media, Government, Coalition

A number of the nation’s most prominent youth sports organizations announced this week that they will be partnering with concussion specialists, sports medicine professionals and leaders at other levels of sports to create an unprecedented coalition to focused on concussions among young athletes.

The announcement comes the same week as a major report on the NFL’s two decades of denial of a connection between football and brain injury, aired on Public Broadcasting System (PBS) stations across the country, including in Connecticut, as part of the investigative “Frontline” series.

The National Sports Concussion Coalition expects to be "the most comprehensive alliance of its kind", with science and medical leaders in the fields of concussions, brain injury and sports medicine working directly with a cross-section of organizations and governing bodies that represent millions of athletes across major organized sports in the United States. The partnership aims to share data and identify best safety practices that can assist in coaching, playing and officiating across sports.

To help ensure the health and safety of young athletes, this past spring the federal government's Centers for Disease Control and Prevention developed the Heads Up: Concussion in Youth Sports initiative to offer information about concussions to coaches, parents, and athletes involved in youth sports. The  initiative provides important information on preventing, recognizing, and responding to a concussion.  A series of fact sheets and an informational video for players, coaches and families are available on the CDC website, www.cdc.gov/concussion.

The founding youth sports and medical members of the newly formed coalition include the National Council of Youth Sports (NCYS), Pop Warner Little Scholars, Sports Concussion Institute (SCI), US Lacrosse, US Youth Soccer, USA Hockey, American College of Sports Medicine (ACSM), Amateur Softball Association/USA Softball, USA Basketball, USA Football and the Datalys Center for Sports Injury Research and Prevention. Coalition partners at the professional, college and foundation levels include the NCAA, NFL, NFLPA and National Football Foundation.

Connecticut Law

Just two weeks ago, Connecticut Governor Dannel P. Malloy and Attorney General George Jepsen issued a news release reminding student athletes, parents and coaches that head injuries and concussions are serious and that Connecticut law requires students who suffer a blow to the head or receive a concussion diagnosis to sit out games and practices until cleared by a licensed medical professional.

“A concussion is a very serious injury, and an athlete who has suffered a concussion needs time to heal,” said Attorney General Jepsen. “While proper use of helmets and protective equipment is important, it’s critical to remember that no helmet can fully prevent a concussion. Preventing head injuries by limiting contact is key. Parents, athletes and coaches should educate themselves in order to recognize the signs of injury and prevent concussions in youth sports.”

Under Connecticut law, anyone who has a state-issued coaching permit and who coaches intramural or interscholastic athletics must be periodically trained in how to recognize and respond to head injuries and concussions. State law also requires coaches to take a student athlete out of any game or practice if the athlete shows signs of having suffered a concussion after an observed or suspected blow to the head or if the athlete is diagnosed with a concussion. Coaches must keep athletes out of games and practices until receiving written clearance from a licensed medical professional.  Connecticut's youth sports concussion safety law was signed on May 18, 2010 by Governor M. Jodi Rell, and the state was among the first in the nation to enact a comprehensive policy.

 “Sports have the power to change the lives of millions of young people in this country by encouraging a physically active lifestyle and by teaching lifelong lessons. We want to make sure no child loses that opportunity due to fear of injury,” said Jon Butler, executive director of Pop Warner Little Scholars. “By coming together in this very important fight against concussions we believe our collective efforts will transcend our individual sports and benefit everyone.”

"The NCAA is committed to broad concussion education outreach, and to research that will identify objective biomarkers and sound management guidelines. We are excited about our partnership in this important alliance," said Brian Hainline, M.D., chief medical officer of the NCAA.

Documentary Production

The PBS program “League in Denial” began as a joint effort between PBS and the ESPN program “Outside the Lines,” announced in 2012.  Earlier this year, ESPN removed itself from the collaborative endeavor.

In a statement at the time, the network said “Because ESPN is neither producing nor exercising editorial control over the Frontline documentaries, there will be no co-branding involving ESPN on the documentaries or their marketing materials. The use of ESPN's marks could incorrectly imply that we have editorial control. As we have in the past, we will continue to cover the concussion story through our own reporting.”

The Bristol-based sports network has initiated major stories on the concussion issue in recent years, and ESPN reporters Mark Fainaru-Wada and Steve Fainaru have written a book – published this week - about football and brain injuries -- "League of Denial: The NFL, Concussions and the Battle for Truth," and are prominently featured in the PBS program.