Concussion testing of diocesan students, now in its third year, continues to evolve, pay dividends
The hit knocked off his helmet and ended with the back of his head crashing into the grass, but Reid Dalton was able to pick himself up and walk off the football field last September. Like any athlete, his first thought was getting back on to the field for his Catholic Youth Ministry team, St. Mary of the Assumption.
But Reid knew something was wrong.
“I kind of felt dizzy. I wanted to play, but I didn’t really feel that good,” he recalled recently at All Saints Catholic School, where he is an eighth-grader. “They made me go through the protocol.”
A trainer instructed Reid to follow her finger, count backwards and remember a few words.
“I messed up a few of them,” he said.
His day, and season, were finished, but his brain was not subjected to further injury.
Thanks to a program initiated in the Diocese of Wilmington two years ago, Reid and just about every other student then in sixth grade had undergone baseline testing, which shows what his normal cognitive levels are. That would help guide the treatment for the severe concussion he had suffered.
Reid went to see Vince Schaller, a concussion specialist and medical director of the Mid-Atlantic Concussion Alliance. Schaller was instrumental in getting the original baseline testing in place. Its value is immense, he said.
“It follows us all the way through recovery so we can see if they’re improving or if they’re doing something wrong and the scores drop off,” Schaller said.
The ability to establish baselines for children as young as 5 years old exists, but the local Catholic schools screen all sixth- and ninth-graders. As of next fall, baselines will exist for every student from sixth grade on except for the few whose parents do not consent to testing.
“That’s all of them, athletes and students. Whether they’re hurt in gym class or wherever,” Schaller said.
The testing is provided free of charge by ATI Physical Therapy, which covers Catholic Youth Ministry football. Lisa Boyer, a sports medicine director at ATI Physical Therapy, said it was a “no-brainer” for the company to offer the testing.
“We felt it was a seamless approach to offer what is best to our students and our athletes,” she said. “ATI is on the sideline at the games, and it was important to us that we also be involved in the prevention and care.”
There have been changes in the last few years since the diocese implemented the program. As noted, there is a pediatric application, and the number of physical therapy groups offering vestibular testing — checking the ears — has grown.
Recovery can last months. Reid was out of school for three weeks and missed the remainder of the football season and a bit of basketball. Initially, he was limited to three hours of television a day, although some patients cannot watch any TV or use a computer. His last checkup with Schaller was scheduled for late February.
“I didn’t really get depressed. I was just really bored. And I got bad headaches the whole time,” he said of his recovery.
Physical therapists, athletic trainers and school nurses are trained in doing the initial screening, and if the vestibular exam is abnormal, the student goes on brain rest and is sent for an ImPACT test. Those results are available to concussion specialists remotely.
“We’re reading them right away and making sure they appropriately referred,” Schaller said.
That is what happened in Reid’s case. The school nurse identified his symptoms and started the post-injury treatment at All Saints.
“Reid was a very complicated case. He had a lot of symptoms and had a hard recovery,” Schaller said.
That includes physical therapy as well as the neurological work. Boyer said concussions usually are accompanied by musculoskeletal injury as well, and the brain and body need to work well together.
Physical therapists are “going past the basics in order to ensure the patient is truly ready to return to all aspects of their daily life,” Boyer said.
Follow the rules
Reid’s mother, Sandi, advises other parents to follow the rules set by the medical professionals.
“That makes a big difference. (Reid) really did a good job of doing what he was supposed to do,” she said.
She also cautions them to expect ups and downs during the recovery period. Sandi Dalton, who has another son who plays football at Archmere Academy, does not want to see contact sports eliminated because of the chance of concussions. She notes that Schaller and the folks at ATI are big fans of football and all sports.
“I think Dr. Schaller makes you realize it’s like any other injury, as long as you treat it the proper way,” she said.
Reid sees football and other sports in his future. As of mid-February, he had narrowed his high school choices down to three schools, all of which offer football. Like his mother, he knows the best way to deal with concussions is to take them seriously.
“We kind of have to,” he said. “We don’t really want to, but you have to follow it or long-term it could mess you up.”