Mallory Long
University of South Carolina
College of Arts and Science
Psychology, B.S.
Graduation with Leadership Distinction: Research
Leadership
A Step-By-Step Solution to Increase Concussion Awareness In High School Athletes
Personal Relevance: During my sophomore-year soccer season at Lexington High School, I suffered from two separate concussions in a two-week time span. My first concussion was an unavoidable soccer accident, I was hit on the side of the head with a soccer ball. On the other hand, my second concussion could have been completely avoided. Despite the constant headaches and nausea, I continued practicing like normal without even knowing that I had a concussion. I know now that continuing to play was a huge mistake. My headaches and nausea worsened, but on top of that, I got hit in the head again. This time the impact was much worse and I lost consciousness. After I acquired the second concussion, the severity of the headaches was almost unbearable. I was out of class for three weeks. I understand that in some cases concussions occur on accident, but in my case, my second concussion could have been avoided with proper prevention and diagnostic procedures. Increasing awareness about concussions will always be very important me, due to my high school experiences. My collegiate experiences learning and conducting neuroscience research over past few years has increased my awareness on the severity of concussions and their potential impact on young athletes. More than ever, I recognize the pertinent need for someone to draw attention to the matter and be the change that could potentially aid in preventing permanent brain damage in young athletes. Though discussing the topic of concussions brings to light many fearful and negative experiences from my past, I illuminate in my Key Insight 2 the need to embrace your fears. Having a concussion is a frightening experience. I plan to embrace the fears that are coupled with sharing and reliving my past concussion experiences, if by doing so, I am able to aid the prevention of concussions in young athletes. Through the process of completing Graduation with Leadership Distinction in Research, I recognize the influential power that evidence based facts can have when it comes to addressing any particular issue. With my background in psychology and neuroscience research as well as my personal experience with concussions, I am in the perfect position to address the issue involving concussions in young athletes.
Background:
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According to the American Association of Neurological Surgeons, a concussion is a brain injury resulting from a severe blow to the head typically culminating in short-term mental incapacities ranging from loss of consciousness, memory impairment, hearing loss, vision loss, and more. The effects of this type of brain injury are still under investigation but have been observed as occurring on a spectrum of severity and vary from one individual to the next.
In order to diagnose a patient with a concussion, the physician elicits a number of tests including an examination of neurological functioning by checking balance, coordination, and reflexes. In conjunction with neurological functioning, cognitive abilities are also observed by having the patient perform a number of tests to evaluate concentration, memory, and ability to recall information. A series of imaging tests (CT scan/ MRI) are also given after a severe brain injury to ensure there was not any life-threatening damage that has occurred.
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Importance:
Many people who experience a head injury do not truly understand the severity and consequences that brain damage can have on them and their well-being. Their ignorance in regards to the effects of brain damage leaves many people to simply ignore their injury and wait for the pain to pass or even continue with their day-to-day lives. Ignoring a brain injury can increase the risks of permanent neurological changes that can alter the mental and physical functioning of the patient. This compelling issue of ignoring an injury is more likely to occur in young student athletes at the high school. This ignorance could be due to lack of understanding of what a concussion is, what a concussion feels like, or even feeling pressured to continue playing despite the injury.
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In a number of my neuroscience courses, specifically my PSYC 420: Developmental Psychology course, I have learned that the brain is still in the process of development until around the age of 25. Therefore young athletes who ignore head injuries and continue to play are more vulnerable to severe alterations in neurological functioning in response to a head injury due to their brain's sensitivity to neuroplasticity. In my Key Insight 3, I illuminate my understanding of neural plasticity. In my PSYC: 460 Physiological psychology course, I was able to learn that neural plasticity is the combination of a number of biological changes that occur in the brain as a result of our experiences. Everything in life that we experience has the ability to physically alter the chemical and anatomical connectivity of our brain. As a result of our past experiences, we each possess differing patterns of neural circuitry, making our cognitive abilities unique. I was able to enhance my understanding about the uniqueness of our brains through my research at the University of South Carolina’s School of Medicine. As a research assistant, I was able to directly observe anatomical differences that existed between the brains of each individual mouse I studied. Learning about the process of neural plasticity and seeing how this process can lead to individual differences, has enabled me to understand the importance of accounting for these differences in concussion prevention and diagnostics.
Goal:
At Lexington High School, my alma mater, current diagnostic procedures being conducted on young athletes fall short in their attempts to accurately determine the extent of an injury for each individual athlete. For instance, due to individual differences in cognitive abilities, one student’s evaluation pre-injury, could look similar to a different student’s evaluation post-injury. Therefore, any given concussion evaluation has the potential to be misinterpreted in regards to the actual severity of the injury. With my growing understanding of neural plasticity I recognize a critical need for a reform in the prevention, diagnostic, and treatment procedures for student athletes at Lexington High School. With the knowledge that I have learned in my Key Insight 1, Seamless Thinking, I will take a non-traditional, more creative approach in order to make the changes needed to reduce the number of student-athlete concussions. My past experiences at Lexington High School have shined the light on the seemingly corrupt prevention and diagnosis protocols involving concussions. Current protocols fail to account for individual differences as well as neural growth and development. In order to address this issue, I will first recommend to provide students, parents, and coaches with information involving the symptoms of a concussion and how to properly prevent the injury from occurring. Next I will recommend the implication of pre-season baseline concussion testing in order to provide an accurate control for each student-athlete to account for individual difference. Finally, I will recommend that the pre-season baseline testing recur for each student-athlete at the start of each year, this will account for the neural growth and development that will occur over the years.
Recommendations:
The advancements in neuroscience research supersede the evolution of prevention and diagnostic protocols for brain injuries, an area of health care that should not be neglected. With that being said, new policies should be designed and executed to account for the advancements in the understanding of individual differences in cognitive abilities as well as long-term effects of concussion in younger athletes. There is a need for an increase in public awareness and education to aid in the prevention of concussions as well as a more effective diagnostic method to account for the individual variabilities across patient’s brains and the continuous changes that occur in cognitive processing with respect to time just within a single individual.
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My Detailed Approach:
I believe that preventative measures for brain injuries should be implemented on two dimensions: prevention of a brain injury occurring, and prevention of worsening any neurological damage after an injury has already occurred. Preventative measures can be taken on the first dimension by teaching young athletes proper mechanisms that can be used in order to prevent an injury from occurring.
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1. I plan to start by first reaching out to Lexington High School due to ease of access. I graduated from Lexington High School. Therefore, I have numerous connections that will provide me with help I need in order to accomplish my goal. I will first get in contact with Lexington’s athletic training department and provide evidence based research on the negative effects of brain injuries. I will explain that in my PSYC 420: Developmental Psychology course, I learned that the brain is still developing until the age of 25 leaving young student athletes at a greater risk for potential long-term effects of concussions. I will then explain the need to educate student-athletes and coaches on ways to prevent concussions from occurring.
2. I will then suggest to provide coaches with training on how to teach student-athletes proper techniques that will help to avoid head injuries. Each training course will be tailored to each individual sports. These training courses could provide instructions that include videos demonstrations on proper tackling techniques in football, and proper heading techniques in soccer, etc.
3. In regards to prevention of worsening damage after an injury, I will suggest providing an educational course for the young athletes and coaches on what exactly a concussion is, what the symptoms are, is and how severe brain damage can be as a result of ignoring an injury. It is important that is information be remembered, therefore, I will suggest displaying posters that contain the crucial information on concussion in various places that can be seen by the student-athletes, such as the locker room.
In PSYC 460: Physiological Psychology, as well as in my research lab, I was able to learn that each brain is functionally, and anatomically unique. Due to my past experiences at Lexington High School, I am aware that current diagnostic protocols for concussion injuries do not account for the individual differences of neurological functioning prior to the injury. In order to account for the individual differences in cognitive processing.
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4. I will recommend to the athletic department that baseline neurological examinations should be provided for each student athlete before being allowed to compete. These baseline examinations would consist of an analysis of cognitive functioning, neurological functioning, as well as imaging. With baseline tests in place for each athlete prior to an injury, physicians would be able to observe deviations in comparison with the students own neurological functioning. This would provide an accurate representation of the severity of the brain injury between each individual athlete.
5. In PSYC 420: Developmental Psychology I have been made aware that our brain and cognitive abilities are continually changing, as a result I believe that just one baseline test for each student athlete is not enough. I will propose that a baseline test is elicited for each student athlete at the beginning of each starting school year in order to account for the cognitive developments. This method of diagnosis accounts for the individual differences in cognitive abilities across the students by providing a pre-injury baseline to compare to if the student is injured. Being able to properly diagnosis a student with a concussion will allow for proper treatment in terms of the severity of the injury and potentially reduce permanent brain damage.
Evaluation:
With the combination of public education and a reform in diagnostic techniques, I am confident that we will see a significant reduction in brain injuries as well as a decrease in permanent brain damage. This plan has the potential to be criticized by the athletic department due to the of cost of eliciting a brain scan for each student athlete each year. The average cost of a CT scan is around $1200. This price could be seen as unrealistic by the athletic department to be able to cover for each athlete. Though this plan has the potential to be criticized by the athletic department for the cost, a student’s health is priceless. With that being said, by raising more awareness of concussions, the parents of the athletes may be more inclined to cover the cost of the CT scan.
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The success of my recommended plan can be assessed and evaluated by athletic trainers, coaches, and parents by eliciting a statistical analysis that compares the documented concussion cases prior to the reformed protocols in comparison to a year after the plan was implicated. The statistical analysis will observe the demographic of athletes that were more prone to concussions over the years. Success will be determined if concussion rates decrease after my plan is initiated. Future reforms to the plan will be centered around the statistical findings. For example, if it is observed that the male lacrosse team had an increase in concussions, it would be important to provide more educational courses that will aid in preventative measures.