Young athletes, students in Western Pennsylvania with concussions receive varied accommodations

| Saturday, Oct. 19, 2013, 9:00 p.m.

High school senior and former defensive end Hunter Horton doesn't mind when his mother reads school textbooks and homework assignments to him — he prefers it.

Depending on severity, accommodations for students with concussions can range from limited computer time and verbal exams to, in Horton's case, exclusion from school.

“I want to go back to school but I know if I try, my grades will drop again,” Horton said, still dizzy from a concentration test Thursday at his doctor's office. “I would have headaches all day.”

The 17-year-old native of Harrisonville in Fulton County went down Sept. 13 when an opponent's shoulder led hard into the left side of his helmet. He stayed conscious and played through the half. But as with any traumatic brain injury, Horton's latest concussion will take a long time to heal.

Horton, who plays for Southern Huntingdon High School, suffered two back-to-back concussions in 2011, and doctors told his mother his brain would heal with rest alone. But this time the headaches persisted. He has difficulty focusing on math problems and does about an hour of school work a day. He said his teachers have been understanding, but being at home for long hours gets boring.

“There is no cookbook approach to concussions,” said Michael “Micky” Collins, director of UPMC's sports medicine concussion program, who has treated Horton. “For students, recovery absolutely depends on the accommodations teachers make in the classroom.”

Deanna Hess, a registered nurse and health services chairwoman at Mt. Lebanon School District, keeps a flow chart.

“First, we follow any recommendations from their doctor,” she said, “but we've also worked hard to be ready in case a student hasn't seen a physician yet or doesn't recognize the symptoms.”

Migraine headaches, loss of focus, fatigue, anxiety, poor vision, bad balance or light sensitivity — every case is different, she said.

“It's not like these kids have a cast on their head,” Collins said. “We have to change the mindset of educators to get them on board. They have to know the right questions to ask.”

Training and patience get tested constantly, Hess said. As many as 100 Mt. Lebanon students suffer concussions every year.

“Right now we're treating three concussions in one elementary school,” she said. “It's a hard thing to get across, even as nurses, that these healthy-looking children who laugh with their friends and want to stay involved are injured and need our help.”

Brian Betta, a Plum Borough High School guidance counselor, said his crew is accustomed to the process.

Teachers have the option to administer tests in stages, provide advanced copies of notes or reduce a student's workload by as much as 75 percent. Some students use audio books, get homework extensions or take time out for short breaks or naps. Hats or sunglasses are OK. Settings on computer screens can be modified to ease eye strain.

“I had a couple students for whom the noise level in the cafeteria was too much while they were recovering, so we adapted,” Betta said. “It has to be a team effort. It can't be a kid trying to advocate for himself.”

Players today, even in high school, are like missiles, said Chip Burke, orthopedic surgeon and former team physician for the Penguins.

“It used to actually hurt when you got hit. (Student athletes) today are bigger, stronger, faster, and the equipment keeps getting better, but our injury rates continue to climb. They fly after each other and think they're invincible.”

In the classroom, teachers with potentially injured players are encouraged to alert the coaching staff if a medically cleared athlete behaves abnormally. Coaches, medical officials, athletic trainers and a battery of sensors and software programs help monitor progress. Often, a student visits the UPMC clinic thinking he or she will ace the medical exam, only to score among the most injured.

“We never want to take a kid out of school unless we have to, but this isn't something you can rush,” Collins said. “We're looking for a return to life. That's much more profound than a return to sports.”

Megan Harris is a staff writer for Trib Total Media. She can be reached at 412-388-5815 or

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