Concussions in school sports: parents ill-prepared for role in reducing kid’s risks

June 14, 2010 Volume 10 Issue 1

Among parents whose children 12 to 17 years old play school sports:

  • Only 8% have read or heard a lot about the risks of repeat concussions in school sports.
  • More than 50% do not know if their children’s school has a policy about returning to sports after a concussion.
  • 62% know of a parent who would have his or her child return to school sports too soon after a concussion.
  • 84% strongly support a requirement that athletes be cleared by a doctor before returning to play after a concussion.

A growing body of research has demonstrated long-term negative effects of repeat concussions in athletes, particularly in children and adolescents. Along with coaches, trainers, and health care professionals, parents play an important role in minimizing the risk of repeat concussions.

To explore parents’ perspectives on concussions among young athletes, the C.S. Mott Children’s Hospital National Poll on Children’s Health conducted a national survey in May 2010 of parents whose children 12 to 17 years old play school sports.

Parent Perceptions of Concussions

Results of this poll indicate that parents’ knowledge of concussion risks is fairly limited. Only 8% of parents have read or heard “a lot” about the effects of repeat concussions, while 36% have not heard or read anything on this topic.

Despite their lack of awareness, parents of young athletes have concerns about concussions: 18% are “very worried” and 45% are “somewhat worried” that their children will get a concussion while playing school sports.

Parents give widely varying estimates on the amount of time that children 12-17 years should sit out after a concussion. About one-quarter felt that one week or less would be fine, while about one-fifth thought it should be more than one month. Sixteen percent felt there should be no specific duration of time before a young athlete returns to play after a concussion (Figure 1).

Are Schools Prepared for Concussions?

As perceived by parents, schools differ in their current services and policies to ensure the appropriate care of young athletes who sustain a concussion. Among parents whose children 12 to 17 years old play school sports, more than half report that the school has a certified trainer onsite for games, but fewer indicate that a trainer is onsite during practices. Only 36% report that their children’s school has a policy about returning to sports after a concussion, while more than half are unaware of any concussion policy (Table 1).

Confidence in Managing Concussions

Parents report varying levels of confidence about how concussions would be handled by other adults in school sports settings. Most parents (85%) agree that coaches or trainers would handle a concussion appropriately. Notably, 62% know of parents who would have children return to school sports too soon after a concussion, and 50% know of coaches who would have a player return too soon (Table 2).

Support for School Concussion Policies

The majority of parents support specific policies related to concussions sustained in school sports. Parents most strongly support requiring a doctor’s clearance before athletes can return to play after a concussion, and requiring coaches to receive information about the risks of concussions (Figure 2).

Garnering the least amount of support among parents is a requirement that schools have a certified trainer or other health professional at both practices and games. There is disagreement on how to fund such a requirement, with parents preferring the following sources:

  • 43% general school budget
  • 28% team fundraising or fees
  • 20% state/federal government
  • 9% health professionals should volunteer

Implications

Researchers have found that youth athletes are more likely than adults to sustain concussions and to take longer to recover. If a repeat concussion occurs before a child’s brain recovers from the first, there is an increased chance of long-term neurologic effects. Based on this research, there have been growing efforts to minimize concussion risks for youth athletes. High school athletic associations, injury prevention organizations, and even professional sports leagues have promoted the implementation of concussion policies, which typically include removal from play for any athlete suspected of having a concussion; clearance by a health professional before return to play; and education of athletes, parents, and coaches about dangers of concussions.

The results of this C.S. Mott National Poll on Children’s Health indicate substantial room for improvement, particularly in the area of educating parents. In this national sample of parents of young athletes, over one-third knew virtually nothing about concussion risks, and half were unaware of whether their child’s school even had a concussion policy.

On a positive note, parents do express strong support for school-based strategies to guard against repeat concussions. However, parents also recognize that some coaches, and other parents as well, would likely have a child return to play too soon after sustaining a concussion.

The involvement of parents in guarding against repeat concussions is critical. Most concussions do not result in loss of consciousness, and some symptoms do not occur until several hours or even days after the precipitating event. Young athletes may be reluctant to tell coaches or trainers about concussion-like symptoms, for fear of losing playing time. Parents, therefore, must understand concussion signs and symptoms and notify school and/or health care personnel if they have any concerns.

Data Source

This report presents findings from a nationally representative household survey conducted exclusively by Knowledge Networks, Inc, for C.S. Mott Children’s Hospital via a method used in many published studies. The survey was administered in May 1-17, 2010, to a randomly selected group of parents of children aged 12-17 who play sports( n=291) from the Knowledge Networks standing panel that closely resembles the U.S. population. The sample was subsequently weighted to reflect population figures from the Census Bureau. The survey completion rate was 56% among panel members contacted to participate. The margin of sampling error is plus or minus 4 to 8 percentage points for this analysis.

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Manager & Editor: Dianne C. Singer, MPH
Data Analyst: Amy T. Butchart, MPH

This Report includes research findings from the C.S. Mott Children's Hospital National Poll on Children's Health, which do not represent the opinions of the investigators or the opinions of the University of Michigan.

[For parents with a child aged 12-17]

Recently, researchers have documented the long-term effects of multiple concussions among athletes.  Several news reports have focused on the risks of concussions among young athletes.

Q1. How much have you read or heard about this topic?  

  • None
  • Some
  • A lot

Q2. Does your child(ren) play SCHOOL sports?
  
[CHILDREN WHO ARE AGE 12-17]
 

  Yes No
[insert age of child]-year-old child    
[insert age of child]-year-old child    
[etc]    

Q3. Thinking about the school sports in which your [INSERT AGE OF CHILD 12-17]-year-old participates, how worried are you about him/her getting a concussion?

  • Very worried
  • Somewhat worried
  • Not at all worried

Q4.  Does your [insert age of child 12-17]-year-old child’s school have any of the following?

  Yes No Don't Know
a certified trainer / other health professional that is onsite for games      
a certified trainer  / other health professional that is onsite for practices      
a policy about returning to sports after a concussion      

Q5.  How long do you think children age 12-17 should sit out from practice and games after getting a concussion? 

  • No specific time
  • 3 days
  • 1 week
  • 2 weeks
  • 3 weeks
  • 1 month or longer


Q6. Please indicate your level of agreement with the following statements: 

Please check one box in each row

  Strongly Disagree Disagree Agree Strongly Agree
If my child got a concussion playing school sports, the coaches and/or trainers would handle the situation appropriately.        
I know of parents who would have their child return to school sports too soon after a concussion.        
I know of coaches who would have a player return to school sports too soon after a concussion.        

Different requirements have been proposed to address the issue of concussions in youth sports. 

Q7. Please indicate your level of support for the following requirements for high school athletics. 

Please check one box in each row

  Do Not Support Somewhat Support Strongly Support
Require high schools to have a certified trainer or  other health professional onsite for practices and games      
Require a mandatory period of nonparticipation in sports after a concussion.      
Require that athletes be evaluated and cleared by a doctor before returning to sports after a concussion.      
Require coaches to receive information about the risks of concussions among young athletes.      

Q8.  If a certified trainer or other health professional were required to be onsite for practices and games, who should pay for it?

(select one answer only)

  • Parents/ player fee
  • Team fundraising
  • General school budget
  • State government
  • Federal government
  • None of the above – health professionals should volunteer

Parent participants were also asked demographic questions on child age, gender, health status, and insurance status. Adults were also asked questions on race/ ethnicity, household income, education, health status and insurance status.

All information is the sole property of the University of Michigan CS Mott Children's Hospital National Poll on Children's Health.  It can only be used if there is an acknowledgment that "The information came from, is copyright by and is owned by and belongs to the Regents of the University of Michigan and their C.S. Mott Children's Hospital National Poll on Children's Health. It cannot be republished or used in any format without prior written permission from the University."

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Manager & Editor: Dianne C. Singer, MPH
Data Analyst: Amy T. Butchart, MPH
 

Click on an image to download the full-size version

Amount of time parents think kids age 12-17 should sit out after a concussion
Current school policies on trainers and concussions
Parents' perceptions of handling concussions and return to sports
Percent of parents who strongly support requirements for athletes and trainers