Push to Protect Public School Students from Concussions

Lilo H. Stainton | September 20, 2016 | Health Care
Children could not return to class or athletic activities without the permission of a healthcare professional

peewee football concussion
Growing concern about the effects of concussions – particularly on young people – has fueled efforts by New Jersey lawmakers to require greater protections for students who have suffered potentially dangerous blows to the head.

“Concussions, especially in young people, should not be taken lightly,” said Assemblywoman Pamela Lampitt (D-Camden), a lead sponsor of a measure that would require students diagnosed with a concussion to obtain permission from a healthcare professional before they could return to class or participate in any school-related athletic activities.

Assembly members showed strong support for the measure, which also requires education experts to create a tailored plan to appropriately reintroduce any student who is issued medical restrictions to classroom activities. “When a child suffers a concussion, there needs to be proper procedures in place for his or her return to school and learning,” Lampitt said.

The measure is inspired by increasing awareness about the danger of concussions and the long-term toll they can take on the brain, sponsors said, as well as new research that suggests children are particularly vulnerable and may need extra time to heal.

A concussion is a serious blow to the head that disrupts normal brain activities — even temporarily — resulting in confusion, difficulty concentrating, memory problems, anxiety, depression or other conditions. While the vast majority of those who suffer concussions do not lose consciousness, it can take days or weeks for the brain to fully stabilize, experts said. The problem can be particularly acute for young people and teens, whose brains are still developing rapidly.

The bill (A-2481), which received unanimous backing in the Assembly Education Committee on Monday, was introduced in February; a Senate panel approved a similar version in March. Nearly two-dozen members representing both parties support each of the bills.

The measure, which applies only to public school students, requires pupils who suffer a concussion to be evaluated by a “licensed healthcare professional” who must issue written permission for them to return to class; the healthcare professional in this case would be a provider whose practice included diagnosing and treating concussion. It also restricts students who sustain a concussion from participating in any physical activity at school, including recess, gym class and any sports activities, until cleared by a doctor.

For students who are given restrictions by a physician, the proposal requires the school district’s “504 team” – a mix of professionals who create education plans for students with disabilities – to take action to ensure the plan is carried out by teachers and other staff. This team is also responsible for adjusting any restrictions and determining how long they should be kept in place.

“Schools should have all hands on deck when a child who has suffered a concussion returns to school,” said Assemblywoman Nancy Pinkin (D-Middlesex). “Having a response plan guided by the recommendations of a health care professional can help spot problematic side effects and prevent aggravating the injury.”

Controversy over the National Football League’s handling of concussions has also sparked new questions about protocols at college, high school and elementary levels, sponsors noted. This intensified after the 2015 Hollywood movie “Concussion,” which featured Will Smith as
Dr. Bennett Omalu, the physician who essentially connected head-blows to Chronic Traumatic Encephalopathy, a form of degenerative brain disease.

An estimated 1.6 million to 3.8 million concussions occur each year, with as many as 30 percent sports-related, according to Assemblyman John DiMaio (R-Warren), a lead sponsor of the bill. Football players have a 75 percent chance of concussion, as do one in 10 athletes in general. An individual who suffers multiple incidents can experience difficulties with learning and memory, among other problems, he said.

“Concussion damage becomes worse with subsequent injuries,” DiMaio said. “These bills will help prevent repeat concussions in young people who can least afford permanent cognitive damage.”

Tom Grady, advocacy and public affairs director for the Brain Injury Alliance of New Jersey, said the bill is important because confusion remains among educators and the medical community about the best response to concussions in young people. “The understanding of recovery from concussion is an evolving field and there are no established protocols for return to learn,” he said, and “this bill will provide a protocol and framework to support students” re-integrate into the classroom.

Lawmakers advocated for a similar proposal last year, which gained widespread, bipartisan support, as well as backing from physicians, educators, and advocates for brain injury patients. But it failed to clear all legislative hurdles before the session ended in January.

While current state regulations require school districts to implement policies to evaluate and protect student athletes who suffer concussions, these do not impact their attendance in class. (Another measure approved yesterday would extend this oversight to intermural athletes as well.)