Health

Concussion Controversy: Who Should Have the Final Say?

Deciding on a kid's 'return to play' is a serious medical move, but some parents and coaches are weighing in

How much of a say should parents have about whether their child goes back into a game after suffering a concussion?

The debate is making its way through the North Carolina state legislature.

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House Bill 116 was “intended to raise awareness of life-threatening sports injuries by having parents, coaches and volunteers sign a concussion information sheet and keeping a database when those injuries occur,” The News & Observer reported this week.

But the bill gives parents and legal guardians “equal standing as physicians and athletic trainers as to whether athletes can re-enter games or be eligible to play or practice the following day after they have been removed.”

Sounds reasonable, right? Not so fast.

“This may be an example of people, perhaps with well-meaning intentions but not considering some of the potential unintended consequences of something like this,” said Williams.

One state legislator said the language giving parents the power to determine whether or not their child is healthy enough to return to their sport should be removed from the bill. Rep. Greg Murphy, a Pitt County Republican who is a physician and supporter of the measure, told The News & Observer that the language will be eliminated. An updated version of the bill stating that only medical professionals can make the determination as to whether a child can go back into a game will move forward. 

Vernon Williams, M.D., a neurologist and director of the Kerlan-Jobe Center for Sports Neurology and Pain Medicine in Los Angeles, along with countless colleagues across the country, couldn’t agree more with the revision.

“My initial reaction is that this may be an example of people, perhaps with well-meaning intentions but not considering some of the potential unintended consequences of something like this,” said Williams.

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Parents, he told LifeZette, may be able to provide some helpful information about how their child is doing to the health care professionals involved: Is the child still exhibiting signs or symptoms of concussive injury? Is he or she having trouble falling asleep or complaining of headaches or losing focus? This information is important in assessing a child’s recovery.

But more often than not, kids will minimize their symptoms, especially to parents — because they want to return to play. There are often incentives for them to return to the game, of course — and if parents are given a say or even an equal say, it could be a disaster.

“We’ve seen in some cases parents who are very aggressive with respect to their desire for their kid to return to play,” said Williams. “But we’ve always been able to say, ‘No, this is a medical decision’ — and the final responsibility has been from the physician or licensed health care professional. And that’s the way it should be.”

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He added that he’s not aware of any other scenario or state where the decision regarding return to play can be made by a parent.

“Typically the buck stops somewhere, and that decision is made by a physician under the best of circumstances — a physician who is skilled in the diagnosis and treatment of concussion,” said Williams. “There are laws in every state now that require some kind of licensed health care professional to be involved in that decision, not just a coach.”

Related: Kids Need to Move After a Concussion

About one in three kids playing team sports is injured seriously enough to miss practice or a game, according to Safe Kids Worldwide, a global network of organizations aimed at preventing accidental childhood injury. Leaving the decision to return to play up to parents, or giving them equal say, is just dangerous, Williams said.

“There can be situations where a parent is pushing for a kid to get back to play. We’ve seen this — where individuals or parents say, ‘Hey, they have a big tournament coming up on Tuesday, why can’t they return to play?’ We’ve done a great job of educating all stakeholders — trainers, physicians, leagues, not just parents and athletes — about the dangers of concussion if it’s not treated properly. I think that we’re still learning what best practices are, and that’s a science in evolution.”

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