Knocked Out: For Kids, Concussions Can Be Worse Than for Adults

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In Texas, Natasha's Law, named after former soccer player Natasha Helmick, was signed by Governor Rick Perry in June after the Senate passed the bill by a 31-0 margin. And, beginning on January 1, 2012, Colorado's Jake Snakenberg Act will take the Lystedt Law one step further by requiring every coach in youth athletics to complete an online concussion recognition course.

Florida, however, recoiled from its own version of concussion safety because Jones, a Republican from Seminole, was miffed that the language did not include the back-cracking set among "medical professionals."

David Goldstein, the Miami high school soccer player, even testified in favor of the bill in Tallahassee. Jones didn't help his cause, recalls Goldstein, by talking on the Senate floor about how standard MRIs can be used to detect concussions, which is a fallacy. Jones filed an amendment to include chiropractors. The house refused to vote on the amended bill; it died on the floor.

After suffering three concussions, Goldstein had been told by doctors to wait it out, never play soccer again, and wish for good luck. It wasn't until he visited the University of Miami — one of the nation's top medical centers for head trauma in student-athletes — that Goldstein's injury wasn't treated as some unfathomable affliction. The doctors slowly worked him back to the point where he could return to soccer wearing a rugby helmet. Now 16, he's a starter on varsity.

Goldstein is the son of the CEO of Royal Caribbean Cruises and attends a high school where the tuition is $28,000 a year. That prompts an obvious question: If his treatment by coaches and trainers was botched, for something that could be prevented by a concussion law, what chance does a regular kid — one whose parents can't pay every specialist in town — possibly have?

Goldstein tried to do something about that. Last year, he organized a raffle at his school and wrote letters asking for cash until he had raised $35,000, which will be donated to the Miami-Dade school district. It will pay for three to four years of ImPACT tests for every public school in the county.

As more states enact concussion laws, medical professionals, athletic trainers, and school administrators wonder whether these laws actually are going to help prevent a condition that's inherently difficult to detect.

"I think the law comes up a little short," says Saint Louis University head athletic trainer Anthony Breitbach about Missouri's Interscholastic Youth Sports Brain Injury Prevention Act, "because a lot of these symptoms are subtle and can be easily concealed by the athlete if he or she wants to play." Additionally, Breitbach estimates that since only half of the state's schools can afford to employ an athletic trainer (which echoes a nationwide trend), a lot of concussions will continue to go undiagnosed, even with the new law in place.

In Arizona, on the strength of Governor Jan Brewer's signature on House Bill 1521, the Mayo Clinic is offering free, online-based concussion tests to more than 100,000 high school athletes.

In June, the Mayo Clinic issued a press release stating that the Arizona Interscholastic Association had endorsed the baseline test, which was not true and caused an AIA attorney to threaten legal action. The two have since made up and are partnering to test all Arizona contact athletes during the 2011-2012 school year, starting with football.

Steve Hogen, athletic director of Mesa Public Schools, had concerns with Arizona's law even before it passed. According to him, if he and his cohorts hadn't been vocal about the bill's language (which was consequently amended), the law would have placed an impossible load on them.

"It put the burden on us that we had to make sure that all Pop Warner football kids were tested. That's impossible. We can't do that," says Hogen. "What if an out-of-state group had come in and they didn't have this concussion testing? We wouldn't have had the resources to check."

Because a legal precedent has yet to be established on these new laws, attorneys are divided on how potential lawsuits will play out in a courtroom.

Steven Pachman is a Philadelphia-based lawyer who has advised numerous academic institutions and athletic entities about concussion litigation. Though Pachman declines to comment about specific clients, a records search shows that he defended La Salle University in a lawsuit filed by the family of a former player. Preston Plevretes claimed that he had received severe brain damage because the school's nurse and a team trainer inserted him back into play too soon following a concussion. (La Salle settled out of court for $7.5 million.)

Pachman says he receives a call each week from advice-seeking youth and high school sports organizations, and "what I'm hearing from the defense perspective — 'We don't have a plan' and 'An athletic trainer is too expensive' — frightens me," says Pachman.

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By Steve Jansen and Gus Garcia-Roberts