Concussion

Connecticut Athletic Trainer Provides Expert Testimony

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Concussion

Connecticut Athletic Trainer Provides Expert Testimony

Legislators are looking to add to the state’s concussion law, in part by requiring a consent form for participation in youth sports leagues on public fields. While there was support for the bill during a public hearing this week, some questioned whether it could be enforced.

A state law passed last year requires a consent form for school-sanctioned athletics, including intramurals.

Under proposed legislation raised this session by the legislature’s Committee on Children, a similar form with information on concussions would be required for youth sports outside of school. The form would have to be signed by a parent to allow their child to participate, said state Sen. Dante Bartolomeo, D-Meriden, co-chairwoman of the Committee on Children. Youth sports organizers would be prohibited from using a state or municipally operated playing field if consent forms aren’t disbursed to parents.

“This is really about just making sure that year after year, time after time, we are continuing to provide education and keep it updated to prevent what can be debilitating effects,” Bartolomeo said.

Similar legislation proposed in the past hasn’t moved forward, she added, due to opposition from some who believe the law would be difficult to enforce and would deter coaches concerned about liability.

“All we’re asking for is education for prevention,” she said.

At a minimum, parents and coaches should be educated on the signs and symptoms of concussions, said state Rep. Diana Urban, D-North Stonington, who co-chairs the committee.

“If I can’t get them to take a whole course, at the very least, we can disseminate information and require that they have it and acknowledge they have it,” she said.

Last year, the legislature passed a provision requiring that youth sports organizers provide parents with information on concussions from the Centers for Disease Control and Prevention. This information is free of charge and is available online, Bartolomeo said.

Coaches of interscholastic or intramural sports are required by law to take an initial course on concussions, and a refresher course every five years. Proposed changes to the law would require coaches to take the refresher course every two years.

Youth sports coaches are not required to take these courses under the current concussion law, but a revision proposed this year would require them to take a refresher course on concussions every two years. Another proposal in this year’s legislation would change the minimum age of participants in a “youth athletic activity” from 7 to 5 years old. The maximum age, 19, would not change. By reducing the age of who is considered a participant in youth athletics, the legislation would apply to more youth sports organizers, coaches and parents, Urban said, thus starting concussion education for children at an earlier age.

At a public hearing on Tuesday, some speakers questioned whether it could be enforced. At least one person felt the bill would prevent some from participating in youth sports.

Theresa Miyashita, speaking on behalf of the Connecticut Athletic Trainer’s Association, said she supported most of the bill but disagreed with a change in the legislation that would extend immunity to the state, municipalities or athletic program operators when educational information about concussions isn’t provided as set out by state law, or if consent forms aren’t collected or disbursed to parents.

“Municipalities and operators cannot be immune” if they fail to comply with the law, said Miyashita, director of the athletic training program at Sacred Heart University.

There is “no way to incentivize or enforce” the law if the parties involved are immune to civil liability, said state Rep. Gail Lavielle, R-Wilton, who is not a member of the Committee on Children but commented on the bill during the public hearing.

“How do you enforce it,” she said. “Give very careful consideration to that.”

Karissa Niehoff, executive director of the Connecticut Association of Schools and the Connecticut Interscholastic Athletic Conference, said she agrees with the legislation’s intent, but took issue with how it might impact children who don’t have parents or guardians who are responsive.

“Not all athletes will be able to get signed consent,” she said.

She recognizes the benefits of organized athletics for children, Bartolomeo said, pointing out that most athletic leagues already require signed consent so it wouldn’t be a burden to sign an additional form relating to concussions. The bill’s intent isn’t to deter children from playing sports, but to educate, she said.

John Cattelan, executive director of the Connecticut Alliance of YMCAs, said there would be an added cost to Y’s across the state to track if each volunteer coach has received the proper training. The legislation would impede the ability for Y’s to recruit volunteer coaches as well, Cattelan stated in testimony submitted to the committee.

There is no added liability for coaches under the proposal, said Steven Hernandez, director of public policy and research for the Committee on Children.

“If a coach acts reasonably to protect the best interest of a child, they are protected by the law,” he said.

Last week, Dr. Anthony Alessi, a neurologist and director of UConn’s NeuroSport Program, spoke to the committee about the impact of concussions on children. He said children are more at risk due to their lack of muscle development. Alessi stressed the importance of education to prevent concussions, especially given the number of youths involved in athletics. Alessi said there are around three million athletes across the country playing youth football. Around one million people play high school football, while 54,000 play college football. There are only about 1,800 people in the National Football League.

State Rep. Noreen Kokoruda, R-Madison, a ranking member of the Committee on Children, said awareness regarding concussions “is fundamental to prevention, and it’s important that children, parents and coaches are well-informed with the risks and ways to avoid concussions.”

A bill raised by the legislature’s Public Health Committee would allow physical therapists to clear student athletes with concussions to participate in team activities. Currently, a student can only be cleared to participate by a physician, physician assistant, advanced practice registered nurse or athletic trainer.

Bartolomeo and Urban both said they were unsure if physical therapists have enough medical background in brain injuries to clear athletes after a concussion. Christopher DiPasquale, a physical therapist from Hebron, submitted testimony Tuesday in favor of the bill. Physical therapists receive extensive training in neurological conditions and manage issues far more complex than those related to concussion protocol, he said. James Leahy, executive director of the Connecticut Physical Therapy Association, made the same case in his testimony.

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