Concussion Testing Pilots Kick Off Fall
August 4, 2015
By Geoff Kimmerly
Second Half editor
The Michigan High School Athletic Association kicked off the 2015-16 school year Monday by hosting 70 member high schools for training in two pilot sideline concussion testing programs aimed at assisting in decision-making regarding the removal of athletes from activity after possible concussion events and record-keeping of those events beginning this fall.
Illinois-based King-Devick Test and Maryland-based XLNTbrain Sport each will be used to monitor approximately 10,000 Michigan high school student-athletes drawn from schools representing all four classes and a variety of regions statewide.
The pilot programs are part of a three-pronged advance by the MHSAA in concussion care this fall. In addition to becoming the first state association to offer pilot sideline concussion testing, the MHSAA will be the first to mandate record-keeping by member schools of all possible concussion events from detection to an athlete’s return to play. The requirement applies to both practices and events, all levels of all sports in grades 7 through 12.
The MHSAA also this fall is the first state association to provide all participants at every MHSAA member high school and junior high/middle school with insurance intended to pay accident medical expense benefits – covering deductibles and co-pays left unpaid by other policies – resulting from concussions sustained during MHSAA practices or competitions. There is no cost to either schools or families.
“These pilot programs are intended to not only improve what’s actually happening on the sidelines at practices and contests in these communities that are part of the pilot programs, they’re intended to spread the word of the need for improved concussion detection across every community,” MHSAA Executive Director John E. “Jack” Roberts said. “We hope these schools involved will become involved in their leagues and conferences and with their peers across the state as we expand the awareness of the need for better sideline detection and provide ways to get it done.”
The MHSAA asked schools at the end of this spring to volunteer for the pilot programs and then selected participants in order to guarantee a variety of schools based on enrollment and location. Schools are committed to involving at least two sports for each gender each season.
Schools participating in the XLNTbrain Sport pilot program are: Adrian, Adrian Madison, AuGres-Sims, Bay City Central, Bear Lake, Brethren, Belding, Birmingham Groves, Brighton, Chesaning, Corunna, Detroit Collegiate Prep, East Kentwood, Fennville, Fowlerville, Gibraltar Carlson, Grand Rapids Christian, Grandville, Greenville, Grosse Ile, Hamilton, Harrison Township L’Anse Creuse, Hazel Park, Kalamazoo Christian, Lansing Christian, Macomb L’Anse Creuse North, Owosso, Pewamo-Westphalia, Portland, Reese, Rochester Hills Lutheran Northwest, St. Clair Shores Lakeview, St. Johns, Stanton Central Montcalm, Vermontville Maple Valley, West Bloomfield and Wyoming Kelloggsville.
Schools participating in the King-Devick Test pilot are: Bay City Western, Benton Harbor, Buchanan, Calumet, Caro, Caseville, Detroit Cody, Detroit Martin Luther King, Fenton, Flint Kearsley, Frankenmuth, Fruitport, Garden City, Grand Ledge, Grand Rapids Northview, Lake Leelanau St. Mary, Lake Linden-Hubbell, Lincoln Alcona, Midland Bullock Creek, Montague, Muskegon, Niles, Pontiac Notre Dame Prep, Romeo, Saginaw Heritage, Scottville Mason County Central, Shelby, St. Charles, St. Joseph, Tawas, Vicksburg, Whitehall and Yale.
The King-Devick Test is a rapid eye movement screening evaluation that requires athletes to read single-digit numbers displayed on a tablet computer in order to detect impairments of eye movement, attention, language, concentration and other symptoms of abnormal brain function. The test has been validated in more than 50 recent peer reviewed articles published in elite medical journals and is associated with the Mayo Clinic.
The test is administered on the sidelines during evaluations for suspected head injuries, and the post-injury results are then compared to an athlete’s preseason baseline. Any worsening of performance (increased time and/or errors) suggests a concussion has occurred and the athlete should be “removed from play” for further evaluation.
“The first and most critical step in managing concussion in the youth athlete is to recognize when one has occurred – not always a simple task,” said Dr. David Dodick, professor of neurology and director of sports concussion services at the Mayo Clinic. “The King-Devick test helps take the guesswork and subjectivity out of the sideline evaluation in a rapid, accurate, and objective way.”
XLNTbrain Sport includes balance and web-based neuro-cognitive tests also used before the start of a season to create a baseline measurement of reaction time, attention, inhibition, impulsivity, memory, information processing efficiency and executive function. The test also assesses mood, anxiety, stress and emotionality.
After a possible head injury, a sideline assessment is done using a smartphone or tablet with those results then compared with the athlete’s baseline measurements. The program documents the severity of a concussion, provides a guide for on-the-field decision making regarding treatment and recovery time and can report results via email to parents, coaches, training staff and medical professionals.
Dr. Harry Kerasidis, who designed the XLNTbrain Sport software, presented at the Coalition for Concussion Treatment Summit at the United Nations building in 2014.
“We included an objective balance test that relies on smartphone accelerometer technology which is effective in the field during practice and game situations,” Kerasidis said. “Should a concussion injury be suspected, the system automatically generates a notification to parents and medical professionals and creates a recovery protocol and post-injury tracking so the right people can monitor the athlete’s progress. Then, the system assists medical professionals with the all-important return-to-learn and return-to-play clearance.”
Click for information on XLNTbrain Sport. Click for information on the King-Devick Test.
For more on Health & Safety, including preseason physical examination, hydration and cardiovascular resources in addition to concussion information and online training sessions, visit the MHSAA’s redesigned Health & Safety web page.
PHOTOS: (Top) Saginaw Heritage athletic director Peter Ryan (right) is administered the King-Devick baseline test by K-D's Samantha Figueroa. (Middle) XLNTbrain Sport creater Dr. Harry Kerasidis provides insight on his program to those being trained to use it Monday.
Working Through Transfer Trends
December 2, 2015
By Jack Roberts
MHSAA Executive Director
One of the responsibilities that schools have asked organizations like the MHSAA to execute is the management of transfer student eligibility. Historically, many associations have linked eligibility to residence ... thus, for some the regulation has been called the “Residency Rule” or “Transfer/Residency Rule,” not merely the “Transfer Rule.”
Over the years, as society became more mobile and families less stable, these rules became more and more complicated; and now, for most state high school associations, this is the regulation that consumes the most (or second) most pages of their handbooks. Over the years, this has also been the regulation most frequently challenged in court.
Over the years, some states have relaxed their transfer rule and others have refined their transfer rule. In either case, the transfer rule remains an imperfect rule, an imperfect net. Sometimes this net snags students who should not be made ineligible, and for those situations all associations have arranged some kind of waiver or appeal process.
And sometimes, and much less easily solved, the net fails to catch the situations it really should ... the transfers that are not hardship related or the result of some very compelling educational need, but those that are obviously for athletic reasons. It is those that we have been most focused on in Michigan.
Our first effort to get at the most problematic transfers was the adoption for the 1997-98 school year of what we called the “Athletic-MOTIVATED Transfer Rule” ... Regulation I, Section 9(E). Examples of an athletic-motivated transfer are included in the rule. The rule only applies to transfer students who do NOT meet any of the stated exceptions for immediate eligibility and are ineligible for one semester under our basic transfer rule. They become ineligible for 180 scheduled school days if there is a finding that the transfer was more for athletics than any other compelling reason.
This effort has not been successful enough because it requires a school that loses a student to another school to promptly allege to the MHSAA office, with supporting documentation, that the transfer was more for athletic reasons than any other compelling reason. The receiving school then must respond to those allegations. Then the executive director makes the decision. The unfortunate result of applying this rule is that it usually causes hard feelings between the schools, and hard feelings toward the executive director by the school decided against. In 17 years, schools have invoked this rule only 45 times.
Our more recent effort to address the most egregious athletic transfers resulted from requests from the coaches associations for wrestling and basketball, which were watching too many students change schools for athletic reasons, usually related to an out-of-season coaching relationship. The new rule – the “Athletic-RELATED Transfer Rule” – is Regulation I, Section 9(F). The difference between Section 9(E) and the newer Section 9(F) is that in 9(F) one school does not have to make and document allegations before staff can act. If MHSAA staff discover or are informed of any of the circumstances listed in 9(F), we can act. Again, the rule only applies to those transfer students whose circumstances do NOT meet one of the automatic exceptions. It applies only to students who are ineligible for a semester under the basic transfer rule. If there is a finding that one of the athletic related “links” exists (usually an out-of-season coaching relationship), then this transfer student who would be ineligible for one semester is made ineligible for 180 scheduled school days.
So far, it appears that 9(F) may be a better deterrent than 9(E). It has been referenced when students are rumored to be transferring, and it has stopped many of those transfers before they occur. We expect 9(F) to be an even better deterrent in 2015-16 because the rule has been broadened to apply to administrators and parents (not just coaches) and to address directing and coordinating athletic activities (not just coaching).
We have said that if this latest effort does not succeed in slowing athletic transfers, then the next step is 180 days of ineligibility – at least in any sport the student played in high school previously – for all transfer students who do not qualify for an exception that permits immediate play. I fear that would catch far too many students who should not be withheld so long from competition and could lead to a period like the early 1980s when the MHSAA, at the request of the state principals association, adopted the core of the transfer rule we have today and which resulted in a period of busiest litigation for the MHSAA when, at one time, the association had more than a dozen cases in court simultaneously on transfer matters. We’ve got to make the current rules work – with tweaks, perhaps; but not with radical revision.