“Concussion is determined as a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces. Several common features that incorporate clinical, pathologic and biomechanical injury constructs that may be utilized in defining the nature of a concussive head injury include:
- Concussion may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an “impulsive” force transmitted to the head.
- Concussion typically results in the rapid onset of short-lived impairment of neurologic function that resolves spontaneously.
- Concussion may result in neuropathological changes, but the acute clinical symptoms largely reflect a functional disturbance rather than a structural injury.
- Concussion results in a graded set of clinical symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive symptoms typically follows a sequential course; however, it is important to note that, in a small percentage of cases, post-concussive symptoms may be prolonged.
- No abnormality on standard structural neuroimaging studies is seen in concussion.”
King has adopted a policy for concussion management that is outlined below.
The ImPACT test is required during fall pre-season for all incoming Grade 9 students and students new to the Upper School. The test will be repeated every two years for all US students. There is an opt-out clause for parents, which needs to be signed before fall pre-season begins.
The Head Athletic Trainer will keep all the ImPACT data and information related to US students who have been diagnosed with concussions.
If a head injury is suspected during a school event:
- the family will be contacted promptly
- the MS or US student will be kept out of athletic activities for a 24-hour period, per Connecticut state law
- for an US student, the ImPACT test will be given again and the pre-season and post-injury data will be given to the family, and/or the School’s neuropsychologist
Internal notification process when a student has experienced a head injury:
The Head Athletic Trainer will email the name of student with the head injury to the Head of Upper School, US Director of Assessment and Instruction, US Counselor, Academic Dean, Nurse, and Athletic Director.
The Head Athletic Trainer will email the name of student with the head injury to the Head of Middle School, MS Director of Assessment and Instruction, MS Counselor, Nurse, and Athletic Director.
If the student’s head injury has been diagnosed as a concussion, the student must be allowed sufficient rest from physical and cognitive demands. The plan must allow him/her to get the most out of the school day without worsening symptoms. There will be a two-pronged approach to management at King.
- There will be an ImPACT re-test for US students.
- Baseline and ImPACT re-test information will be shared with parents and/or School neuropsychologist.
- Students may not take part in athletics until the following occur:
- Gone one week without symptoms
- Checked by Head Athletic Trainer; for example, through activity like riding the stationary bike, having a discussion, and answering specific questions
- Cleared by a physician
Activities that require concentration and attention (eg scholastic work, video games, text messaging, TV, computer work, etc.) may exacerbate symptoms and possible delay recovery. Activities listed above should be monitored based on the individual student’s status. Cognitive Rest accommodations include the following:
- During the initial period, emphasize with student and family that physical and cognitive rest are extremely important.
- Support healthful sleep and rest by encouraging students to arrive at school late, or leave early.
- Decrease sound and light exposure, which intensifies headaches.
- Avoid over-stimulation, eg dining hall, gymnasium.
- Limit screen time – computer, cell phone, TV
- Regular check-ins with Advisor
- Allow for untimed tests or assignments.
- Postpone tests or exams until a physician clears the student and the student agrees that he/she can concentrate and study effectively. Even if a student has been cleared for athletics, there may be an additional period before he/she is prepared to take tests/assessments or complete large projects.
All concussion management needs to be sensitive to the individual needs of the student and all decisions will be made at the discretion of the physician, the student, and the parents.
Concussion management is an ever-changing program, which is constantly being reviewed and studied. We will continue to stay informed about current research and adjust the protocol accordingly.
 McCrory et al., 2008. Concensus Statement on Concussion in Sport 3rd International Conference on Concussion in Sport Held in Zurich, November 2008. Clinical Journal of Sports Medicine, 19, 185-200.