Currently, many teams leave it up to the athlete to determine if they’re okay to play after a head injury. But we know how ferociously determined a young athlete can be: “I feel fine! Put me back in!” Allowing them to return after a short rest can be dangerous. Often, concussion symptoms such as headache, dizziness, nausea, and vomiting may not show up immediately and can even take several days or weeks to develop. Returning too soon also puts an athlete at risk for further injury due to impaired balance and reflexes. With that in mind, I’d like to offer parents an easy, very helpful way for them to practice due diligence in preventing long-term harm to their children: a simple preseason cognitive test. Baseline cognitive testing can be done preseason annually or every other year to provide a snapshot of a child’s “normal” brain function in a noninjured state. The testing includes checking for current concussion symptoms and examining balance and cognitive function. Testing typically includes either a computerized or paper-and-pencil quiz that assesses concentration, memory, and reaction time. Having this preinjury assessment goes a long way in measuring and understanding the impact of a child’s potential head injury and whether he or she has recovered from concussion. It also allows a healthcare professional to make objective, scientifically backed decisions about a child’s ability to return to play.
An Accessible and Inexpensive Solution
Baseline cognitive testing is already a standard in college and professional sports. It could also be accessible to all youth athletes — if it is made a priority. But without parents pushing for it, it likely won’t happen. Cognitive tests must be conducted by a trained healthcare professional, but not all high school or club teams have access or funding for an athletic trainer. So, it’s left up to the parents. Luckily, baseline cognitive testing is relatively easy. Most large hospitals or healthcare systems provide the testing. It’s quickly incorporated into one visit (or even online), and it only costs between $15 and $50, depending on your provider. So why not make this testing a yearly or biyearly priority — just like getting your child’s vaccines or making it part of an annual back-to-school checkup? Some health systems and concussion centers even offer them at no charge. I work with a colleague at Banner – University Medicine Neuroscience Institute to provide free tests to the community. I recommend parents contact local hospitals and health systems to see what might be available to them. Every parent will tell you that they would do anything to protect their child from injury — and baseline cognitive testing should be a part of that. Having a standard for each child’s cognitive function can provide the information needed to know when it’s safe to allow them to return to play. More importantly, it could prevent more serious head injuries that could have devastating consequences. Team sports are not only fun for kids, they are also an invaluable way to stay healthy and to learn critical life skills, such as understanding the importance of teamwork, building confidence, accepting adversity, and respecting authority. Parents can give their children this important opportunity, while also taking this prudent precaution. Steven Erickson, MD, is a physician who specializes in concussions at Banner – University Medicine Neuroscience Institute. He is board-certified in sports and internal medicine and is the medical director of Banner – University Sports Medicine and Concussion Specialists. He leads a team of medical experts who have extensive knowledge in the evaluation, treatment, and management of concussions — physicians including neuropsychologists, physical and occupational therapists, and athletic trainers.
