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. 

CAP Begins 2014-15 on Record Pace

August 22, 2014

By Geoff Kimmerly
Second Half editor

Gretchen Mohney has come to recognize coaches who think they already know it all.

Then she begins a Coaches Advancement Program lesson by describing an orange banging around inside a fishbowl – a metaphor to explain the brain inside an athlete’s skull when he or she suffers a concussion.

Her most powerful lessons have moved pupils to tears. And it’s always gratifying to witness the “Aha” moments that make the CAP educational experience so powerful.

“My favorite is when they admit that they’ve done something wrong, and they want to know how to do something better,” said Mohney, a highly-respected trainer and strength and conditioning coach who also serves as an instructor for the athletic training program at Western Michigan University. “It’s a pretty awesome moment when they realize there’s more to learn.”

More current and aspiring coaches than ever before are taking advantage of that opportunity as the 2014-15 school year kicks off. 

Since this training year began July 25 at Battle Creek Lakeview, 273 current or aspiring coaches have completed CAP sessions – nearly twice as many coaches as this point a year ago and with the last session of August planned for Saturday at New Buffalo. That makes this the busiest start in CAP history, according to MHSAA assistant director Kathy Vruggink Westdorp, who joined the MHSAA staff in 2004, developed CAP for the 2004-05 school year and continues to oversee the program.

This first month’s total attendance also represents 33 percent of the 818 total CAP units completed at high schools and the MHSAA office during all of 2013-14.

“I think the big thing continues to be word of mouth that this is a quality program,” said Hamilton athletic director Jerry Haggerty, a CAP instructor for nine years. “It’s good for all coaches of all experience levels.”

Setting a standard

Since the program’s inception, nearly 6,300 coaches have completed at least the first-level unit. More than 1,000 have advanced through CAP 4.

The CAP program is broken into six levels, each addressing a set of topics:

  • CAP 1: Coaches Make the Difference, The Coach as Teacher, Sports Medicine and First Aid.

  • CAP 2: Effective Communication, Legal Responsibilities, Psychology of Coaching.

  • CAP 3: Additional Coaching Responsibilities, Effectively Working with Parents, The Coach as Performer.

  • CAP 4: Understanding Athletic Development, Strength and Conditioning, Preparing for Success.

  • CAP 5: Healthy Living, Teaching Emotional Toughness, Resolving Conflicts in Athletics.

  • CAP 6: Current Issues and Topics in Educational Athletics.

“Individuals who go through this have a better understanding of their philosophy, their school’s philosophy, their role and responsibility as well as the meaning behind MHSAA rules,” said Westdorp, a former principal, athletic director, teacher and coach in the Grand Rapids area who was named 2013 Coach Educator of the Year by the National Federation of State High School Associations (NFHS) for her work with the program.

She trains and evaluates all presenters and instructors, including those who last school year administered 1,238 CAP sessions at seven universities and colleges across both peninsulas.

The non-college CAP sessions are taught by 20 instructors who pride themselves on being available anywhere there’s interest. CAP has been presented at 10 Lower Peninsula schools over the last month, with Upper Peninsula sessions planned for this fall. August 9 was particularly busy – units were taught at Jonesville, Pontiac Notre Dame Prep and Riverview Gabriel Richard – but Westdorp sees the possibility of presenting at up to five sites on the same day.

Flexibility also is an option; a group of mostly non-school coaches took CAP 2 last week in Baldwin, and were able to complete the course over two days instead of one so they could do so without interrupting their fulltime jobs. For coaches working in schools, CAP units can qualify as continuing education credits with the State Department of Education.

Colleges and universities in Michigan are licensed to present up to five levels through their undergraduate or graduate studies, and the list of those who completed courses the last few years is filled with recognizable names of former high achievers on MHSAA courts and fields. Southwestern Michigan College in Dowagiac will offer courses for the first time this fall.

Certification in the program occurs after completion of CAP 1 and 2, and then after each subsequent unit, with those completing CAP 6 earning Masters Elite Certification.

The topics of CAP sessions “bleed” into each other, Mohney said, and come with plenty of first-person examples to make them relevant to coaches who then realize they aren’t alone facing issues most encounter.

“I talk to them because I’ve been there. … (I say,) ‘Now, let’s talk real.’ I place them in a real situation,” Mohney said. “’The biggest thing is you guys don’t have to know everything. You just need to coach, be aware of this, this and that. And these are some ideas to go about your plan so you can decrease your stress.’

“Any time a coach hears that, it’s a beautiful thing. Because I’m not sure what coach in high school is in coaching for the money.”

Raising the bar

Certainly, some of this month’s heightened CAP participation can be attributed to an MHSAA Representative Council action in March. Beginning Aug. 1, 2016, varsity head coaches hired for the first time at an MHSAA member school must have completed CAP 1 or CAP 2. Westdorp said some who wish to become head coaches in that near future are getting a jump by completing CAP courses now.

But that’s only a slice of the success story.

Haggerty has directed Hamilton’s athletic department for 15 years and said all of his coaches have taken either CAP 1 or 2. Many coaches take the courses on their own; others are required to do so by their athletic directors.

The Capital Area Activities Conference will offer CAP 1 three times this school year, with 100-150 coaches from their 20 member schools expected for each session. Others leagues and conferences are designing similar arrangements.

Michael Roy coached boys basketball at Lawton and girls hoops at Vicksburg and was certified under the predecessor to CAP – the MHSAA’s former Program for Athletic Coaches’ Education (PACE). He’s beginning his 13th year as Vicksburg’s athletic director, and after hosting several CAP classes over the years decided to begin the program himself this month.

“The need for knowledgeable and experienced coaches is greater than ever before. I thought if I was going to make it mandatory for my coaches to become CAP certified, that I needed to get CAP certified and lead by example,” Roy said. “The heart of any athletic team or program is its coaching staff.  CAP is the surest way for coaches to access everything they need to know how to be a good coach. They learn the art of effective coaching through one of the best-designed coaches education programs in the country. CAP is second to none.”  

Haggerty has spoken with athletic directors who have completed the program and then recognize when their coaches employ strategies learned at CAP sessions. An increasing pool of coaching candidates are heading into interviews with CAP certification in hand, and Westdorp has seen coaches bringing their CAP binders to practices to have those lessons available for quick reference. She’s also watched many CAP graduates using their skills at the highest level – the MHSAA Finals.

A comment by Duke men’s basketball coach Mike Krzyzewski sits at the front of those CAP binders: “A common mistake among those who work in sport is spending a disproportional amount of time on x’s and o’s as compared to time spent learning about people.” 

Haggerty starts each session telling his pupils, “I do this for two reasons; one because I think it’s important to look at the non-x and o coaching realms; and two, because this is great fun for me.’”

And those coaches who come into CAP thinking they know enough? Mohney said most finish the first unit looking forward to beginning the next.

“CAP has a lot to do with understanding what you’re about, understanding your role and responsibility in athletics and your leadership role,” Westdorp said. “When I start programs, I talk about my work roles in life, and then (I tell coaches), ‘I want to tell you where I felt I was more influential, and that was as a coach.

“’And don’t ever forget it..’”

Click for more on the Coaches Advancement Program.

PHOTOS: These coaches, counter-clockwise from top left, all have completed at least one CAP unit: Bay City Western softball coach Rick Garlinghouse, St. Ignace girls basketball coach Dorene Ingalls, Ypsilanti Community boys basketball coach Steve Brooks, Beal City baseball coach Brad Antcliff and Mattawan softball coach Alicia Smith.