New Pa. concussion law falls short
A law that protects students on the playing field when they endure a concussion does nothing to help them upon returning to a classroom, experts say.
Brain injury specialists say the Pennsylvania Safety in Youth Sports Act, which took effect in July, is a good law but does not address all concussion-related issues. Student athletes now get testing before they can return to play, but no law addresses what happens to any student with cognitive problems after a concussion.
“Our worry was that people weren't going to pay attention to return to school,” said Brenda Eagan Brown, coordinator of BrainSTEPS, a school re-entry program developed by the Brain Injury Association of Pennsylvania for the state Health and Education departments.
Her concern appears to be well-founded. The only state policy dealing with academics and concussions is one meant to accommodate students taking achievement exams, said Tim Eller, an Education Department spokesman. It excuses a student with severe symptoms from taking the test and does not penalize the school.
Experts say concussions can cause students to have trouble learning because of persistent headaches, dizziness, vision and memory problems. Because public schools receive government money, they're obligated to accommodate youths with disabilities, including concussion-related problems.
Using Centers for Disease Control and Prevention data on concussion rates and the state's school-age population, the Brain Injury Association estimates that 20,000 school-age children in Pennsylvania get concussions each year.
Yet parents and students say some schools are better than others at responding to learning problems that arise from concussions. In a few cases, parents have hired lawyers to intercede.
Student: ‘I couldn't comprehend anything'
Pam Bonnett, 19, said she initially received little help for the concussion she got when a softball hit her in the head in 2010 while she attended Penn Hills High School. She developed sensitivity to lights and noise that made finishing her sophomore year impossible.
“I still tried to go,” said Bonnett, an A student. “But I was just like a body there. I couldn't comprehend anything.”
Bonnett said her neurologist recommended complete rest, but it took three weeks for school officials to agree to homebound schooling.
“I don't think they ever believed me as to how bad it actually was,” Bonnett said. “They would just tell me to do the work. I would say that I honestly can't.”
District spokeswoman Teresita Kolenchak confirmed the district does not have a specific concussion policy.
“These situations are looked at on a case-by-case basis because, for example, a concussion could have symptoms ranging from severe cognitive loss to occasional headaches,” Kolenchak said. “Each student would need to be accommodated differently.”
Brown said her younger brother had similar problems when they were growing up in New Castle.
“The big focus was on his broken bones because you could see he had broken bones,” she said. “People couldn't see his traumatic brain injury because he looked totally normal when he returned to school.”
That experience led her to obtain a master's degree in the educational aspects of brain injuries and to lobby the state Department of Health to develop BrainSTEPS six years ago.
Funded by federal grants, the program provides specialists to three school districts and 27 of the state's 29 intermediate units, which help other districts. Oregon is the only other state with a comparable program, Brown said.
The specialists guide students, families and schools on what to expect from a brain injury and how to cope with symptoms.
BrainSTEPS in Pittsburgh
Someone must alert the BrainSTEPS team when a student with a concussion needs help.
Ilene Elinoff of Squirrel Hill was surprised to learn Pittsburgh Public Schools has a BrainSTEPS team.
For more than a year, she has tried to get the district and administrators at Sterret Middle School to help her son with headaches and vision problems he developed as a result of a concussion during an October 2011 hockey game.
An honors student taking advanced math, his grades slipped from A's to C's.
“Instead of him being tutored or helped, I would receive phone calls saying he was lazy and not applying himself,” Elinoff said.
When she hired a lawyer, the district agreed to help, Elinoff said. Attorney Rebecca Heaton Hall contacted the school board's solicitor and asked that the district evaluate Elinoff's son as required under the federal Rehabilitation Act and develop a plan to help him.
District solicitor Ira Weiss said he cannot comment on individual cases but said the district does not have a specific policy for dealing with student concussions.
“I think it's handled through the normal student health process,” Weiss said.
In the past year, BrainSTEPS began offering schools training to set up their own concussion management teams, Brown said.
About 80 percent of youths recover from concussions within four weeks. School-based team members can help monitor their symptoms and academic progress and alert BrainSTEPS specialists to step in if a student needs more help, she said.
So far, 149 school districts, 16 private schools and five career and technical centers have formed two-person teams. Brown's goal is to establish a team in every school, or at least every district.
“We're going to keep offering (the training) on a rolling basis, in the hopes of getting them all,” she said.
Some schools took action to go beyond the Safety in Youth Sports law.
Norwin School District adopted a concussion policy in January 2012, after the law passed but before it took effect.
“We said to ourselves that we probably needed something for more than just athletics,” said Tracy McNelly, assistant superintendent of secondary education. “The most important thing is to not interfere with the healing.”
Fox Chapel Area School District adopted its concussion policy last spring, based on BrainSTEPS protocol, said Melissa Adams, the school psychologist.
A concussion management program saved Devin Nestler's freshman year at Montour High School, his father said. Nestler, 15, of Robinson developed symptoms after his first football game — headaches and blurred vision — so BrainSTEPS taught him eye exercises and told him to use prism glasses, which help his eyes focus.
“I watched my son suffer, and the only reason he's getting through it is because of this program,” said Rick Nestler.
Dr. Sue Beers, associate professor of psychiatry at the University of Pittsburgh School of Medicine, said it understandably took time for districts to recognize the serious consequences of concussions, because the medical profession began taking them seriously only in the past 20 years.
“When I started my research in the mid- to late '80s, some scholars that were overseeing it asked if mild head injuries were really a problem,” Beers said.
Researchers know more than they once did but acknowledge there's more to learn about how concussions affect the brain and its recovery, Beers said.
Even if a school provides help, students and parents face tough choices.
Sophia Ketricola, 16, of the North Side had two concussions in seven months at the start of the school year.
Kelly Eckert, her mother, said they had to decide whether to pull her from classes at Winchester Thurston School in Shadyside for more than a month, or ask her doctor to prescribe a neurostimulant. The drug would help her during classes but would not help heal her brain.
Ketricola didn't want to risk being held back for a year, so they chose the drug. Yet Ketricola said that trying to learn while dealing with headaches, dizziness and memory problems is frustrating.
“All the doctors tell you to just chill out and not do anything, and I wasn't able to do that,” she said.
Eckert wishes concussion patients had better choices.
“I didn't like either option,” she said. “As far as when is her brain going to heal, I don't know, and that really bothers me.”
Brian Bowling is a staff writerfor Trib Total Media. He canbe reached at 412-325-4301or firstname.lastname@example.org.