Tracking Missouri

youth athlete 


Who holds MSHSAA’s concussion reports accountable?

For parents and coaches of school athletes, safety is a high priority. In 2011 Missouri passed a bill to track concussions in youth sports. The goal was to protect student athletes. KBIA’s Rachel Thomas explains why enforcing this law is so difficult and what it means for student athletes.

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Rock Bridge Basketball Team
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Pat Lacy: Athletic Director

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Missouri Pushes for More Concussion Prevention


By: Rachel Thomas, Sierra Morris, Jiayi Wang and Meiying Wu


In fall of 2015, Bennett Lawson, a sophomore at Rock Bridge High School, made head-to-head contact with a teammate during a warm-up before a football game. Lawson’s coach and trainer recognized concussion symptoms and immediately pulled him off the field. Lawson was not allowed to return to play until he received clearance from a health professional a month later.


Lawson was just one of more than 3,000 reported incidents of youth athlete head injuries in Missouri in 2015. Because of Missouri’s youth sports brain injury laws, he was prevented from returning to play until he had recovered.


Since 2014, all 50 states have created legislation to address youth athlete brain injuries. Most states have laws similar to Missouri’s. They require concussion education, immediate removal of athletes on suspicion of concussion and returning them to play only with approval from a doctor.


However, Missouri is attempting to take concussion prevention a step further. It is the only state whose law requires an annual report on youth sports brain injury.


Starting in 2011, the Missouri State High School Activities Association compiled youth athlete concussion data from its public school members. According to Missouri law, MSHSAA is required to publish an annual report, known as the Interscholastic Youth Sports Brain Injury Prevention Report, and distribute it to its member schools.


However, there are loopholes in the law that allow inconsistent data and a decline in schools participating in the report.


There was a 10 percent decrease in schools that reported from 2015 to 2016 and no penalty for schools that did not report.


Greg Stahl, MSHSAA’s assistant executive director, said this decrease could be due to several factors. He said the submission date for the 2015-2016 report occurred in the summertime when some schools are closed. School administrators, who only have nine or 10 month contracts, are unable to work during that time. MSHSAA hopes to increase school participation by moving the submission date earlier before schools close for the summer.


The law requires MSHSAA’s report to be submitted to education committees within the state House of Representatives and state Senate. However, the committees do not take time to review the report.


Bryan Spencer, vice-chairman of the House Committee on Elementary and Secondary Education, said there isn’t enough time or resources for any committee to oversee the data within the report.


“Nobody looks at it, until there is a problem,” Spencer said.


The lack of oversight enables MSHSAA to pick and choose what data to include in their reports. In 2014, the number of member schools included in the report dramatically decreased. MSHSAA decided to exclude middle school data from the report.


Despite the inconsistent number of schools included in the reports, the rate of youth sport head injury in Missouri has increased by 40 percent since 2012.  


Harvey Richards, previous MSHSAA associate executive director, said this increase is not due to more concussions, but is because the increased concussion education and training have equipped more coaches, trainers and parents to recognize and report signs of concussions.


In order to address this, Richards said MSHSAA will be adding more specific questions to next year’s report.


“Were you removed from play? Yes. When you came back was it diagnosed as a concussion? So we’re going to get two sets of numbers there. So the numbers will even look different next year,” Richards said.


MSHSAA’s past reports only include occurrences when youth athletes were removed from play because of symptoms of concussion. Not all occurrences in the report were diagnosed concussions.


Despite the difficulties that accompany enforcing an annual report, tracking youth sports brain injuries is beneficial. If Lawson were to have another concussion in the future, Rock Bridge High School would be able to track his head injury history. The school can use this data to keep track of its individual students, as well as overall trends for each sport.


Pat Lacy, Southern Boone County R-I School District’s athletic director, said before Missouri created its youth athlete brain injury laws, coaches and student athletes didn’t take head injuries as seriously.  


“[Athletes] went back into athletic events, maybe even on the same day, if they had a head injury in a football game. It just wasn’t looked at like it is now,” Lacy said. “Now we have trainers on the sidelines. They’re going to make the decision, they’re going to say, ‘no they’re not going back into the contest.’”


By tracking their students’ head injury trends and history, Southern Boone school district coaches noticed head injuries occurring consistently in soccer. In response, Lacy said they’ll be purchasing concussion headbands for all of their high school soccer players. The headbands will lighten the impact of any hit to the head.


The youth sports brain injury data collection is unique to Missouri not only by state comparison, but nationally as well. There is currently no established national surveillance system to gather and track national youth sport brain injuries. It is currently impossible to compare Missouri’s youth athlete concussion data to accurate nationwide estimates because they don’t exist.


The Centers for Disease Control and Prevention want to change that. Since 2016, the CDC has been advocating for a National Concussion Surveillance System that will monitor national trends and see the effects of prevention efforts. The system is estimated to cost $5 million.


According to the CDC, only one out of every nine concussions nationwide may be reported with the current data sources. If implemented, the National Concussion Surveillance System would compile its data by a nationwide household telephone survey. The survey would include how many children and adults had concussions and the cause of injury.


With nationwide data on concussions, the CDC said it will be able to provide national estimates specifically on youth sports concussions and people living with a disability caused by brain injury.