The way Nebraska schools handle concussion injuries remains inconsistent despite a state law requiring they identify and manage injured students’ return to the classroom and sports, advocates told the state board of education.
“It’s a continual process, and it’s not part of the culture yet,” said Peggy Reisher, executive director of the nonprofit Brain Injury Alliance of Nebraska. “It’s more than just awareness, it’s figuring out how to recognize and manage students with brain injuries.”
Reisher and board member Sharon Royers asked the state board of education Friday to become a leader in helping change that culture by creating a model policy for schools to follow to assess and monitor students who have suffered brain injuries.
The state passed the Concussion Awareness Act in 2012, which required all schools and youth sports groups to educate coaches, athletes and parents about the dangers of concussions; remove injured students from play; and require written approval from parents and health care professionals before they returned.
In 2014, the law was amended to widen the response, requiring that schools establish protocols for returning students to the classroom after a brain injury and for providing necessary accommodations.
Lincoln Public Schools was the first district in the state to establish such protocols, including concussion management teams — comprised of administrators, counselors, the school psychologist and nurse and athletic trainer — that oversaw students’ return to the classroom.
But a survey conducted in 2016 by the University of Nebraska-Lincoln’s Center for Brain, Biology and Behavior showed not all schools are aware of the protocols.
Just 63 percent of schools had people designated to oversee students’ return to the classroom, and just 71 percent offered concussion training to classroom teachers.
There’s been improvement since 2013 in many areas, UNL’s study showed. The number of schools with a written policy for removal and return to play for students with concussions increased from 63 percent in 2013 to 91 percent in 2016.
In 2013, just 6 percent of schools had “return to learn” policies, and nearly 84 percent did three years later. And by 2016, all schools made concussion training available to coaches.
But in 2016, just 88 percent of coaches or athletic trainers reported removing athletes with a suspected concussion, which advocates said should be higher by this point.
Most schools manage concussions through their athletic departments, but a third of students suffer concussions outside of athletics — in accidents, falls on the ice, on the playground or in P.E. classes, Royers said.
The response needs to include parents and doctors to be effective, and parents need to tell school officials when students are injured outside school, Royers said.
It’s important schools designate someone responsible for following up, and training for all school staff is important, she said. A school secretary who gets a call from parents saying a child is staying home after hitting their head should know to notify others at school so they can respond appropriately.
“The state school board can be a leader in defining all these things,” Reisher said.
Protocols only work if they're used consistently, and for too long the discussion has been focused on athletics, the advocates said.
“It’s been stuck in that little silo,” Royers said. “We really need to get it down to the classroom level.”