NORWELL - Jeannine Donato remembers the dreaded phone call she received two years ago, and how she feared the worst: Her youngest son, Nolan, had been hurt during his hockey game. He had been hit from behind, and his head slammed against the boards. He was taken to Children’s Hospital in an ambulance.
When Donato arrived at the hospital, Nolan seemed confused and his head was pounding - he had suffered a concussion. Doctors in the emergency room asked whether Nolan had ever had a “baseline’’ test done before. Unfortunately, he had not.
Baseline testing is an important tool for evaluating concussions, and helps doctors determine when an athlete should return to playing. The computerized exam - described by many as a “preseason physical for the brain’’ - is given regularly to athletes at the collegiate and pro levels, as well as in high school contact sports. But in the world of youth sports, it’s not as common.
After her son’s concussion, Donato made it her mission to make this type of testing more accessible to young athletes, through an initiative she calls “A Head of the Game’’ (www.a-headofthegame.com). Since launching this effort in October 2010, the Scituate mother has single-handedly tested more than 250 youngsters, most of whom are still in grade school.
“That’s my goal,’’ she said, “to get to the younger kids.’’
The mother of four is well suited for the job. She is a registered nurse who has dealt with such injuries while working in the head trauma unit of Brigham and Women’s Hospital in Boston. Her children play sports, and her husband, Ted, is a 13-year National Hockey League veteran who played for the Boston Bruins and now coaches the men’s hockey team at Harvard University.
Until her son got hurt, Donato had never heard of Immediate Post-Concussion Assessment and Cognitive Testing - better known as the ImPACT test. Now she spends much of her time administering this test to 11- and 12-year-olds.
The ImPACT test is part video game, part puzzle, part brain teaser. It can be done almost anywhere. All Donato needs is a quiet room where she can set up a laptop computer.
The test consists of six modules: word memory, design memory, X’s and O’s, symbol matching, color match, and three-letter memory. These exercises measure the athlete’s cognitive functions.
After the athlete finishes the test, which takes about 20 minutes, the results are scored and ranked by percentile. This provides a snapshot of the athlete’s cognitive abilities - such as recall, attention span, reaction time, and pattern recognition - and shows how quickly his or her healthy brain processes information.
Tom Damelio is an eighth-grader who skates on a bantam team for Pembroke Youth Hockey. Damelio took the ImPACT test under Donato’s watch in November, and he said it was well worth it.
The test “had simple directions, and it didn’t take too long,’’ said Damelio, 14. “It was kind of what I expected.’’
Donato says she will provide the baseline test results to parents, and in the event of injury, she will fax the child’s baseline results directly to the doctor’s office. If the athletes suspect they have suffered a concussion, they would take the ImPACT test again - within 24 to 72 hours after their head injury - and the results would be compared with their previous scores.
The difference between pre- and post-injury test scores can be dramatic. Donato cited one case in which an athlete scored in the 75th percentile on one part of the exam. After suffering a concussion, the same athlete took the test again, and ranked in the 1st percentile. Luckily for the youngster, the effects of the concussion were temporary; after getting lots of rest and proper medical care, the brain began to heal and the test scores started to improve.
“Usually if the kid does the right thing, they’ll heal,’’ said Donato.
When that same athlete took the test again 12 days later, the score was back up to the 55th percentile.
For medical professionals, baseline testing data can be an invaluable tool to evaluate an athlete’s progress as he or she recovers. The test results can also help the athlete decide whether to return to regular activities, or whether more rest is warranted.
“We never know how long it’s going to take [someone] to recover from a concussion,’’ said Dr. Janet Kent, who runs the Sports Concussion Clinic at South Shore Hospital, where ImPACT testing is offered regularly to athletes age 18 and under.
Kent recommends that “any child that participates in a contact sport, ages 11 and up, should get baseline-tested every two years.’’
“It’s extremely useful to have a baseline,’’ she said. “It’s even more important in children.’’
This type of computerized neurocognitive testing is relatively new, but it has grown increasingly popular in recent years, especially among collegiate and pro athletes. The ImPACT test, which was developed in the early 1990s, is now used by teams in Major League Baseball, the NHL, National Basketball League, and National Football League, as well as thousands of colleges and high schools across the country. It’s also used by the acrobatic performers of Cirque du Soleil and professional wrestlers in the WWE.
ImPACT testing is given to many high school and collegiate athletes south of Boston as well.
On some weekends, Donato sets up shop in an office park in Norwell and books appointments there. She charges $40 per test; the exam typically isn’t covered by health insurance, she said.
“I discount the test if I get a group rate. I would, of course, waive the fee if a parent came to me that could not afford the baseline’’ testing, she said.
To make it as convenient as possible for parents, Donato says she also brings her laptops to hockey tournaments and other venues where young athletes congregate. This allows more youngsters to get tested.
“My main goal is to bring this to different places,’’ she said.
Her latest rounds have included Walpole Youth Football - several Walpole football players suffered concussions last fall, she said - the South Shore Kings hockey program, as well as the Providence Capitals, a youth hockey organization based in Rhode Island.
Kent said she is glad that Donato is spreading the word about baseline testing and trying to make it available to the younger set. More parents of young athletes are taking notice.
“I think the awareness is increasing,’’ Kent said.
Kent and Donato are helping to organize a symposium called “Play Smart: Concussion Prevention in Youth and Interscholastic Hockey,’’ to be held tomorrow at The Lantana in Randolph. The event is sponsored by South Shore Hospital and will feature talks by Kent, noted concussion expert Jason P. Mihalik, NHL Hall of Famer Pat LaFontaine, and appearances by hockey legends Tony Amonte, Paul Stewart, Bob Sweeney, and Ted Donato.
The symposium is free, and coaches, referees, athletic directors, league organizers, school leaders, teachers, emergency medical providers, and parents are invited. RSVP is required. To register, call 781-624-2335.