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CDC to Create National Youth-Concussion Guidelines

APConcussions_400.jpg

The Centers for Disease Control and Prevention will be developing a national protocol for the prevention and treatment of concussions in student-athletes, two U.S. lawmakers announced Tuesday.

The CDC's action comes as a response to the Concussion Treatment and Care Tools (ConTACT) Act, which stalled in Congress after being passed by the House of Representatives in September 2010.

The ConTACT Act would have required Secretary of Health and Human Services Kathleen Sebelius to "establish concussion-management guidelines that address the prevention, identification, treatment, and management of concussions in school-aged children" within two years of its passage. Within four years of its implementation, the secretary would be required to report to Congress how many states had adopted the guidelines and data regarding concussion frequency and second-impact syndrome among youth athletes.

But since the ConTACT Act never made it past the Senate Committee on Health, Education, Labor, and Pensions, the CDC is taking matters into its own hands.

The CDC will form an expert panel during the next year to "define the need, scope, and expectations of these federal [concussion] guidelines for student-athletes," said Rep. Bill Pascrell Jr. (D-N.J.) in a statement.

Pascrell and Sen. Robert Menendez (D-N.J.), the two lawmakers who announced the CDC's news today, were the primary sponsors of the ConTACT Act in the House and the Senate.

"We used to see concussions as minor injuries that didn't necessitate much medical attention. What we now know about the brain has now helped us all to see that every concussion is brain damage, and that we must do more to protect our children," said Pascrell.

"The guidelines that the CDC would develop will take in advice from experts across the country, laying the foundation for all 50 states to implement a standard and protect our young athletes," he continued.

The panel is expected to finalize guidelines and recommendations for pediatric mild traumatic brain injury (aka, concussions) by fall 2013, according to the lawmakers' statement.

"This fall—when parents are watching their sons and daughters play playing their hearts out, we want them to know that everything possible is being done—and has been done—to prevent a life-changing injury on the field," said Menendez.

The CDC's guidelines will not be mandatory; they'll simply serve as recommendations for schools and districts coping with new youth-concussion laws.

Schooled in Sports' Protocol Predictions

So, what might we expect to see in the CDC's recommended youth-concussion guidelines?

Three provisions in Washington state's Zachary Lystedt law, which the National Football League considers a model for youth-concussion laws nationwide, are as good of a bet as any. They are:

• Requiring a student-athlete's parent or guardian to sign a concussion-awareness form before the student-athlete is allowed to participate in athletics (either practices or games);

• Removing from play any student-athlete who is suspected of sustaining a concussion; and

• Requring student-athletes with concussions to obtain medical clearance before allowing them to return to play.

Beyond that, states' current youth-concussion laws begin to vary widely.

Roughly half the 33 states (along with the District of Columbia) that already have youth-concussion laws call for some form of mandatory training for coaches. Some states require coaches to go through annual training; others only call for one-time training or training every few years.

A handful of states extend the training requirements past coaches to school nurses, athletic trainers, and other school staff members involved in extracurricular athletics.

And there are plenty of areas that state concussion laws haven't begun exploring, as a few concussion experts explained to me earlier this summer.

Christine Baugh, the research coordinator at the Boston University Center for the Study of Traumatic Encephalopathy, specifically noted that current state laws fail to "limit the overall number of impacts incurred by these student-athletes, at least in any meaningful way."

Look for baseline concussion tests to become more popular, too. A student-athlete takes the baseline test before the start of the season to measure his/her level of typical brain activity when healthy, then retakes the test after potentially suffering a concussion. Doctors compare the results and can determine the severity of the concussion based on how different the student-athlete's responses are.

"Athletes vary tremendously on these tests," said Dr. Mark Lovell, the chief executive officer of ImPACT, a Pittsburgh-based company that issues baseline tests, "and if you don't have a baseline, it is difficult to detect change in the case of mild or subtle injury."

In short, there's ample room for youth-concussion laws to grow. The CDC concussion panel has plenty to pore over these next two years.

Photo: U.S. Rep. Bill Pascrell, center left, stands next to Nutley High School football players as he announces that the Centers for Disease Control and Prevention will be developing national guidelines for managing sports-related concussions for student-athletes, during a news conference on Tuesday in Nutley, N.J. (Julio Cortez/AP)

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