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.
A League of Their Own in Illinois
May 20, 2014
By Rob Kaminski
MHSAA benchmarks editor
Imagine the scene: thousands of spectators roaring their approval as hundreds of cross country runners hit the finish line. A couple thousand others cascade applause on the wrestling mats as referees raise the hands of 19 champions.
Now, here’s the kicker, imagine this is taking place during postseason play for junior high/middle school student-athletes.
Again, that’s postseason, and junior high/middle school.
“I guess when you see a kid cross the finish line in first place and 5,000 people are cheering, or watch a student run a race, throw the shot, or pole vault in front of that many at our track & field series, the proof is in the pudding,” said Steve Endsley, executive director of the Illinois Elementary School Association.
“The environment, the feedback we get; it’s the greatest thing in the world to some who experience our tournaments. But, I temper that in saying this is not the Olympics, the pros, or even high school. Success at our level doesn’t guarantee future success. We want you to do your best, we want to prepare you to do your best, but understand this is junior high.”
If understanding that is difficult for some athletes and parents involved in IESA athletics, it’s also a foreign language to state high school associations across the country. The IESA is the only organization in America which exclusively governs interscholastic activities for grade levels 7-8.
Most states include junior high/middle schools in their rules and regulations, but few, if any, conduct tournaments.
“We’ve been doing it for so long, it’s accepted. Schools know that at the end of the regular season, they enter Regional play. The payoff is we have state series, a culminating activity, and it’s a good thing that’s going on,” Endsley said.
From the organization’s first postseason event in 1930 during which boys basketball tournaments took place in a lightweight (boys less than 100 pounds) and a heavyweight division, the IESA has grown to sponsoring more than 20 boys and girls activities.
Measures have been taken in recent years to alleviate travel concerns at the end of the season. The IESA has added classifications in some sports, while keeping the number of teams which advance to the Finals the same. So, for instance, where 16 teams might have gone to two different sites in the past, now four different sites host eight schools.
Admittedly, Endsley adds that the tournament series might add to some competitiveness, but since all schools enter the tournament, there might be less emphasis on winning during the regular season, and thus, heightened participation for those of all skill levels.
“If you don’t want the win-at-all-cost mentality, then step up to the plate at your member school and handle it that way,” Endsley said.
The refrain from association leaders around the country is that success in conveying the values and ideals of school sports is totally dependent on those in charge at the local level. Beginning with the 2012-13 school year, the IESA put more of that load squarely on the individual schools by making it a local decision as to whether students could participate with the school team and a club team in the same sport during the same season.
“From an association standpoint, it seemed like only people we were penalizing when had the limitations were the honest schools which self-reported,” Endsley said. “It was difficult to penalize those schools while everyone else knew the school down the street didn’t report.
“In a perfect world, the participation rule would be in place. But, it’s not a perfect world. Club sports schedule in accordance with high school seasons, but disregard our level when it comes to non-school activity. It’s year-round. So it’s practically impossible to equitably enforce it from a state level.”
There are more than 800 member schools in the IESA, which is an affiliate member of the National Federation of State High School Associations, but a separate entity from the Illinois High School Association.
Endsley estimates the IESA comprises 50-60 percent of eligible schools in Illinois, bolstered by unique membership options which differ from the IHSA and many state associations.
“We offer a la carte membership. A school can offer activities and maybe not participate in our state series. It’s only in those activities in which schools participate in the IESA state series that they must abide by our rules and regulations. Schools want some control. I think a la carte way is the way to go.
“If they join the IESA for one sport, they receive all mailings and information, so maybe one sport gets them in, but they may later add activities. If they are not a member, they don’t know about us.”
Yet, while separate bodies, the IESA and IHSA work hand-in-hand in many respects since nearly 100 percent of the IESA’s students will matriculate into IHSA schools.
“We attend the IHSA activity advisory meetings so we can keep a finger on the pulse of topics they are discussing and items they are considering. From the student standpoint, we will take our champions and introduce them in ceremonies at the IHSA Finals when our calendars line up,” Endsley said. “They get tickets, halftime introductions, pictures in the program, and it’s well-received recognition.”
Such activities are possible because the IESA seasons are different than the IHSA’s in some sports, or end sooner. For instance, the IESA plays baseball and softball in the fall, so its champions are recognized at the IHSA Finals in the spring.
“These activities create exposure and help build interests and aspirations for our schools,” Endsley said. “It’s nice P.R. for both associations.”
Whether different seasons or same seasons, the multitude of events throughout Illinois provides ample opportunity for the state’s contest officials as well. That’s another area in which the IESA and IHSA work together.
“We don’t license officials in the IESA, but we require our schools to use IHSA officials,” Endsley said. “We get great cooperation from the IHSA, it’s a good situation for our schools, and it’s a really good thing for officials. There are always plenty of games, and new officials gain valuable experience.”
Now in the midst of its ninth decade, the IESA continues to expand, adding boys and girls bowling and golf to its roster of activities in 2011.
The Association sponsors athletics for 7th- and 8th-graders, but 5th- and 6th-graders enrolled in a member school may participate with 7th-and 8th-grade teams within that building without a waiver. If such students are in an elementary school which feeds a member school, waivers are necessary.