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State revises concussion reporting after weak response from schools

State requirements for tracking head injuries in football and other high school sports are designed to help school officials address student safety.Jim Davis/Globe Staff/File 2010

After abysmal compliance by many school athletic directors, the state is revising how it requests information on students’ head injuries from local school districts.

Less than a third of schools statewide have complied with a new law that required them to report sports concussions and other head injuries by last August. Many athletic directors and other school officials have said they were unaware of the deadline, or were confused by the form and exactly what information to include.

As the state begins to collect data on head injuries sustained by students during the school year that just ended, a new reporting form highlights the submission deadline — Aug. 31 — in bold type, and is much more specific about what is required. It includes “data definitions’’ to help schools provide accurate reports.


Even with the limited data collected last year, a top state official said, it is clear that head injuries pose a significant public health issue in Massachusetts schools.

“The numbers of concussions reported by the schools was rather dramatic,” said Carlene Pavlos, interim director of the state Department of Public Health’s Bureau of Community Health and Prevention.

The state found 3,450 students had suffered a head injury or suspected concussion in “extracurricular athletic activities” during the 2011-2012 school year, across the approximately 213 public and private middle and high schools that reported their data. About 689 schools were supposed to submit their numbers under the law, which was enacted in 2010.

Among schools in Boston’s suburbs, Needham High reported the highest figure, with 85 head injuries, followed by Lexington High, with 69 incidents, and Scituate High, with 62, during the 2011-12 school year.

As alarming as those numbers may sound, state officials cautioned that the figures are not conclusive.

“It was clear that a number of the schools didn’t really understand what the form was asking,” Pavlos said.


The lackluster reporting comes at a time when parents, coaches, and health officials have been immersed in the dangers of head injuries, especially repeated incidents. From Pop Warner to the National Football League, organizations have limited contact in football practices, and officials in other sports are beefing up awareness or evaluating equipment to try to mitigate concerns about potential long-term damage to the young athlete’s brain.

Nonetheless, athletic directors in many Massachusetts school districts said they did not know about last year’s reporting requirement.

Asked why Chelmsford High did not turn in its data for the 2011-2012 school year, athletic director Scott Moreau said he had the report due next month ready to go, but is unsure why the first year’s numbers never made it to the state.

“I don’t know why, to be honest,” he said. “There was probably some confusion. . . I don’t think people actually totally knew that it had to be reported.”

Steve Traister, who started as athletic director in Dedham a few weeks ago, said he did not know why the town’s high school had not reported its head injury numbers. And he said he also did not know why Milton, where he had been athletic director last school year, did not turn in its form.

He noted that awareness about the dangers posed by head injuries has been on the rise in recent years, with a focus on not letting students return to play too soon as a way to avoid serious long-term damage.


“It’s very hard to prevent concussions,” said Traister, stressing that education and awareness are critical.

Those are the key components behind the state law, which, in addition to the reporting requirement, mandates return-to-play protocols and concussion-awareness training for students, parents, coaches, and staff.

And that is really the point of the data collection as well, said Pavlos. There are no specific plans to analyze the figures, she said, but requiring that the records be kept is important to make the public, coaches, parents, and health personnel aware of the prevalence of head injuries.

There are other tools for tracking concussions and other head injuries, such as the state’s youth health survey and hospital discharge data, she said, making the reports from schools “one piece of a much larger data puzzle.”

Her department is also performing a small-scale review of the quality of policies in place, she said, to make sure schools are in compliance with the new law and to see whether additional technical assistance is needed.

Pavlos, like other experts, warned that the numbers of concussions reported will likely go up in the next few years as awareness continues to increase.

Last fall, the Globe reported preliminary figures for the 2011-2012 school year. Initially, Boston College High School was at the top of the list with 76 reported head injuries.

Another 40 schools turned in their numbers after the Globe story. A few of those posted high totals, with Needham’s figure the highest in the state.


The figures show the scope of concussions in school activities, but many experts say another concern is high schools with low numbers, which may indicate the school is ignoring the problem.

“Kudos to Needham for putting in an infrastructure with the proper training and that they caught hopefully the majority of the concussions,” said Chris Nowinski, the executive director of the Boston-based Sports Legacy Institute, which works on issues surrounding concussions in sports.

At the other end of the reporting spectrum, some schools with significant athletic offerings reported head injuries of zero or in the single digits.

“What’s really scary is these schools that had zero did not have zero, and that means concussions aren’t being diagnosed,” said Nowinski.

He said he was disappointed but not surprised about the inaugural year’s weak reporting response.

“I do believe it’s important to collect this data because we’re trying to understand just how big of a public health problem concussions are at the high school level, and if we don’t know how many are happening, we can’t appropriately respond,” he said.

Marblehead High School reported a fairly typical number of head injuries, 26 for the 2011-2012 school year. Mark Tarmey, Marblehead’s athletic director, praised the new law, saying it was “long overdue.”

The real challenge, he said, comes over the summer or other times when classes are not in session. Tracking concussions during team activities is relatively simple compared with getting information on head injuries outside of school-supervised events.

“I think our biggest challenge is we can monitor and document concussions that happen during our practices and games, but when a kid goes skiing with his family or is jumping off the docks in July . . . we have no control over that,” said Tarmey.


Peter Rittenburg, Brookline’s athletic director, said his missing report from last year was simply an oversight, and noted that the high school has been tracking head-injury numbers since before the law went into effect. He was recently preparing his second-year data, unaware that the first year’s report was never submitted.

The numbers have been pretty stable from year to year, Rittenburg said.

To tackle underreporting, Brookline has launched outreach and education efforts, he said. Students who try to hide a concussion sometimes give themselves away because of symptoms that pop up in the classroom.

Teachers are often the ones to notice that a student, who had not confessed to any symptoms, is struggling in the classroom — a classic sign that had gone unheeded before concussion education became routine, said Rittenburg.

“It’s an important crusade for sure,” he said. “And it’s added work for everybody but it’s important work.”

Lisa Kocian can be reached at lkocian@globe.com. Follow her on Twitter @GlobeLisaKocian.