Concussions: Being Smart About Your Child’s Brain

The New York Times
Frank Bruni Frank Bruni DEC. 19, 2015
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PROBABLY no one tracks concussions among young athletes in the United States more closely than Dawn Comstock, and in many ways, she’s encouraged by what she sees.

It’s now less common for a player whose head has collided violently with a ball, a wall, the ground or another player to return to competition right away. It’s now more common for him or her to get medical attention.

But Comstock, an epidemiologist at the Colorado School of Public Health, is frustrated by stubborn gaps between truly safe behavior and the status quo. She told me that more than half of the high schools with football teams don’t have a full-time athletic trainer, so there’s no immediately available person with the specific mission of preventing and treating injuries.

There are also sports other than football — and trauma other than concussions — that don’t attract nearly the vigilance they should, she added. Above all, there’s an enduringly strange, dangerous relationship between parents and sports, specifically between parents and coaches.

“What I would love to see is parents taking as much time to investigate their child’s coach, the league that they’re putting their child into and the officials officiating the game as they do a day care center when their child is young,” she told me. “They don’t have trouble challenging a teacher, even a pediatrician. But somehow they have trouble challenging a sports league.”

This coming week, the major Hollywood movie “Concussion” opens. It stars Will Smith as a scientist who sounded the alarm about the long-term impact of repetitive head injuries in professional football.

And it reflects a storm of attention over the last decade to the serious, sometimes fatal damage done to the vulnerable brains of football players of all ages — and of soccer players, too. We’ve learned, for example, that soccer carries a greater risk of concussion for girls than it does for boys.

But the talk of a “concussion crisis” and the pronounced concern about football and soccer are blinding us somewhat to a larger picture, a broader lesson: Our veneration of sports, our adulation of athletes and our ethos of toughing it out put kids needlessly at risk of all sorts of preventable injuries in all kinds of improvable sports.

“I worry that we’ve been so focused on football that parents are pushing their kids out of that and into something else and not realizing that there are dangers there, too,” said Kevin Guskiewicz, one of the directors of the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center at the University of North Carolina at Chapel Hill. “We need to improve safety in all the sports that children play.”

Did you know that while the incidence of injuries in cheerleading is much lower than in the majority of high school sports, nearly a third of those injuries are concussions? The reason, Comstock explained, is a shocking lack of common sense and caution in monitoring an activity that isn’t automatically associated with violence.

 

“We’ve seen cheerleaders who’ve sustained concussions because they were practicing on the asphalt in the parking lot or on the cement sidewalk — or in the school cafeteria on a tiled floor,” said Comstock, adding that grass or mats would be infinitely more appropriate. “Why on earth would parents let that happen?”

Guskiewicz drew my attention to a study published just a few months ago in The American Journal of Sports Medicine that determined that among college athletes, concussions were most likely in wrestling, followed by men’s ice hockey and then women’s ice hockey. And women’s soccer and women’s basketball, in that order, were right behind football in terms of the danger of concussion.

Comstock, who supervises an ongoing national inventory of athletic injuries among high school students, said: “I have 22 sports in my surveillance system, and concussions have been reported in all but one of them. That includes swimming.” A distracted kid will swim head-on into the wall or into someone coming from the other direction. The sport without concussions, she said, was tennis.

BUT head injuries are just one peril, and not necessarily the chief one, even in football. There are many more deaths among football players of all ages from indirect trauma, including heatstroke and cardiac arrest, than from such direct trauma as head and spinal-cord injuries.

Douglas Casa, the chief executive officer of the Korey Stringer Institute at the University of Connecticut, said that from 2000 through 2009, which was the last full decade studied, such indirect-trauma deaths outnumbered direct-trauma deaths by 108 to 41.

Casa, who monitors and compiles that data, told me that he knows of 14 deaths among football players below the college level since July 1, which is about when practice for the fall season usually begins. Four were from cardiac arrest and two were from heatstroke.
“Anytime you hear about a kid dying from heatstroke in high-school football, it was 100 percent preventable,” he added. And he said that there are an even greater number of preventable cases of severe heatstroke that leads not to death but to prolonged or permanent health complications.

Last August, for instance, a 16-year-old in Riverhead, N.Y., who developed heatstroke during practice ended up in the hospital, where he spiked a 108-degree fever, was treated for serious kidney damage and spent the next five weeks.

Casa said that heat acclimatization — or the incremental acceleration of practices during a season’s start — can guard against heatstroke. But while many leagues and teams have implemented that, many haven’t.

Players’ posture can affect the likelihood of head injury but often isn’t studied and adjusted. And Comstock said that there’s no widespread, dependable monitoring of the nature and incidence of injuries among athletes in elementary and middle school.

“Don’t get me wrong: I’m not against sports,” she said. “I was a three-sport player. And I played contact sports. I played rugby for 13 years.” She and Guskiewicz both stressed that, at a time when too many kids are obese or diabetic, they want more of them to play sports.
But they also want more prudence in the mix. Some parents obsess about a high school’s success or failure in getting kids into Ivy League colleges but know nothing of the school’s athletic teams’ safety protocols. Some question the amount of homework more readily than the number of laps athletes run on a 95-degree day.

Some shop for lenient physicians who will declare their child healed and let him or her back out on the field. Athletic glory beckons.

“Sports has achieved an almost mythologized place in our country,” Comstock said. She’s wrong about the “almost.” She’s right about this: It’s not concussions per se but an unquestioning worship of sports that puts young lives in jeopardy.

Millions of teens are using a new app to post anonymous thoughts, and most parents have no idea

The Washington Post

By Moriah Balingit December 8
Millions of teenagers in high schools nationwide are using a smartphone app to anonymously share their deepest anxieties, secret crushes, vulgar assessments of their classmates and even violent threats, all without adults being able to look in.

The After School app has exploded in popularity this school year and is now on more than 22,300 high school campuses, according to its creators. Because it is designed to be accessible only to teenagers, many parents and administrators have not known anything about it.

Envisioned as a safe space for high schoolers to discuss sensitive issues without having to reveal their names, After School has in some cases become a vehicle for bullying, crude observations and alleged criminal activity, all under a cloak of secrecy. Similar to Yik Yak — an open app that has become popular on college campuses — After School allows teens to post comments and images on message boards associated with individual high school campuses but carries nothing identifying the students who post there.

“At first it was people saying nice things and complimenting others, and then it turned into bullying,” said Mya Bianchi, a 15-year-old who attends Ionia High School in central Michigan. Mya said a user posted her phone number along with instructions to contact her for photos, a message that was punctuated by a winking smiley face and icons of a camera and a bikini. After receiving harassing messages, she had to change her number.

“After School” is a social media app that allows teens to post anonymously on message boards closed to adults and provides a space to ask difficult questions without revealing their identities. This video describes safety features the app’s creators added following criticism that it allowed students to post bullying messages as well as threats. (After School)
Her mother, Carrie Bunting, said Mya was “freaked out” to be getting messages from unknown numbers. It also irked Bunting.

“They’re underage children,” Bunting said. “I don’t feel like there should be something that excludes parents.”

Cyberbullying has been around nearly as long as the Internet, and teens have taken conflicts and taunts to social media on platforms such as Facebook and Twitter, as well as via text messages. The real-life people behind those digital missives are usually known; on After School, users are anonymous, and some say that has enabled and even encouraged cruelty and threatening behavior.
After School limits its audience to teens by requiring users to verify that they attend high school through their Facebook pages and by creating restricted message boards for each high school campus. Parents and others who want to access the app would have to lie to do so, saying on Facebook that they attend the high school. Even then, parents could be stopped by an algorithm that aims to block people from posing as high school students.
Popular here, nationally

The app’s creators declined to say exactly how many students use After School, but they indicated that there are somewhere between 2 million and 10 million users. There are approximately 55­­­ million K-12 students in U.S. public and private schools nationwide, with about 15 million in public school grades 9 through 12, according to the Education Department.

The app is extremely popular at high school campuses across the Washington area; at the private Sidwell Friends School in the District, which President Obama’s children attend, 119 students were signed up as of Friday. Robinson Secondary School in Fairfax, Va., had 700 students who use the app; at Walter Johnson High in Bethesda, Md., 245 students are on it.
Cory Levy, 24, one of the app’s founders, said After School gives teens a chance to “express themselves without worrying about any backlash or any repercussions.” He said the app is a new way for teens to ask difficult, uncomfortable questions anonymously and to more directly address issues such as depression, how to come out as gay to one’s parents or how to navigate the daily challenges of teen life.

Levy said the product creates a much-needed alternative to Facebook and Instagram, where teens have grown up carefully curating digital identities that might not reflect their true struggles and anxieties. After School allows them to be themselves without worrying so much about what other people will think, he said.

“There’s a need for people to be able to communicate in a place where they wouldn’t be judged, where they could speak freely,” said Michael Callahan, 32, who created the app with Levy. He sees it has having “therapeutic” potential.
Students say that most comments are benign, and Callahan said problematic posts are a tiny sample of the millions of messages that appear on the app’s boards.

But there have been complaints about cyberbullying and anonymous threats on the app since shortly after it first appeared in November 2014. A month after its debut, a 17-year-old at Brandon High School in Ortonville, Mich., threatened an attack in a series of After School posts, including one that read, “Id rather take my AR 15 to school and practice on my classmates than to the gun range,” said his attorney, Deanna Kelley. He pleaded guilty to making a terrorist threat and using a computer in a crime and was sentenced to 90 days in jail. Kelley said the teenager made the threats because he was upset about bullying on the app, which included racial slurs.

Protests spur changes
Students started online petitions asking Apple to remove After School from its App Store, with one saying: “with the shield of anonymity, users have zero accountability for their posts, and can openly spread rumors, call classmates hurtful names, send threats, or even tell someone to kill themselves — and all of these things are happening.”

Apple pulled the app from its store that same month, and a new version was released in April, promoting a long list of enhanced safety features, including a fast-response system that contacts authorities if a threat is detected. While After School has no information on the identity of users, it does keep cellphone data that can help police trace a post to a particular device. The app is now equipped with a warning system so that a teen who posts a worrisome message about being depressed or distraught will be sent a message asking if they would like to text with a counselor. More than 50,000 users have had text conversations with trained crisis counselors, according to the app’s creators.

“We wanted the users to feel very safe on After School,” Levy said. “We want them to feel like if there’s something that they’re curious about but they don’t want their identity associated with, they can ask it.”
Levy said that an algorithm automatically blocks posts with certain verbiage — like those that urge other students to harm themselves. And he said other posts are reviewed by dozens of moderators who screen for cyberbullying and harassment around the clock; users also can report individual posts to have them removed. Callahan said the bar is very low for what is banned: Even a comment such as “Michael is a slow runner” would be blocked. If they are aware their child is using the app, parents can now set filters to block certain content.

Recent posts to the app indicate that some inappropriate messages still get through, and students at several high schools said that bullying and harassment are frequent. Students — who shared screen shots from the app with The Washington Post — said they have seen taunts against others for being gay, people’s bodies being scrutinized, boys declaring which sex acts they would like to perform on specific girls.

One anonymous poster at Florida’s Yulee High School called a student out by name and then wrote: “I’d like to corrupt her.”

“I just think it’s kind of insulting, and they don’t respect people like they should,” said a 15-year-old girl who attends Yulee.

Threats posted
Last month, a user posted a photo of a gun on After School with an accompanying threat about something “going down” at Robert E. Lee High in Springfield, Va., leading to a police investigation. Lucy Caldwell, a Fairfax County police spokeswoman, said a student saw the post and reported it to school authorities, who notified police. Investigators never determined who posted the threat.

“Unfortunately, these kinds of apps are often used to create fear and disruption,” Deirdre Lavery, principal of Lee High, wrote in a note home to parents. “We thank you for working with us to discourage our students from using these apps to cause concern for our students and our families.”

Police in Warren, Mass., on Monday charged an 18-year-old senior with making a threat via After School, saying the teenager admitted to posting a message that read: “For all those who enjoy living . . . don’t go to school tomorrow ;),” according to Officer Jeffrey Von Dauber.
Quaboag Regional Middle High School was then put on high alert, and just about 20 percent of the school’s students showed up for class the next day as police worked closely with After School to trace the threat to the student using cellphone data, police said.

Nicole Deaton is a senior at Brandon High School in Michigan, where memories of the day when students were too scared to show up at school because of the threat posted by their classmate are still fresh. Deaton said the app remains popular — more than 725 students at her school are signed up — and many of the posts reflect tortured teenage romantics and secret admirers.

“Most of it is not bad at all,” Deaton said.

Levy and Callahan said that the rare threats they have seen are against the terms of their app’s user agreement, meaning that anyone posting a threat on After School is violating those rules and possibly committing a crime. They said they are dedicated to school safety and see their app as a venue for important discussion; they have helped authorities when posts have crossed the line, using cellphone data to track users in cases of alleged crimes.

“We all need to work together to end school violence,” Callahan said. “We are all on the same team, the parents, the school and us. We are all trying to make positive impacts on the lives of teens.”

Mark Sale, principal at Swain County High School in rural North Carolina, said After School arrived on his campus sometime last month, and administrators immediately scheduled an assembly to warn students of its potential dangers. His hands already are tied when it comes to social media, because he can only discipline a student for conduct online while at school or in a school activity. After School poses a new challenge because Sale doesn’t know which student is saying what.

Just last week, an anonymous poster made cruel remarks about a student’s appearance, prompting a call from the girl’s distraught mother. Sale wants to protect his students, but he said he can’t track the app’s use, can’t stop students from using it and said he has one perplexing question: “What can I do about this?”
Moriah Balingit writes about education for the Post.

What do Students Lose by Being Perfect? Valuable Failure

Mind Shift

By Holly Korbey

AUGUST 12, 2015

In the first pages of Being Wrong, Kathryn Schulz writes, “In our collective imagination, error is associated not just with shame and stupidity but also with ignorance, indolence, psychopathology, and moral degeneracy.” This cultural terror of messing up, combined with modern modes of parenting and schooling obsessed with narrow versions of academic and career “success,” are making students more than risk-averse.

Books like How to Raise an Adult and Teach Your Children Well say kids are coming to college “underconstructed,” at best unsure of who they are and where they fit, at worst anxious and depressed, because their parents have protected them from the uncomfortable and unacceptable state of being wrong. Focused on getting the grades or winning the game and excused from helping out around the house, these children have internalized the pressure, and it’s morphed into a monster that paralyzes kids in their ability to take risks, screw up, find out the consequences and learn from their mistakes.

Parent and educator Jessica Lahey, author of the new book The Gift of Failure, wants parents (and teachers) to back off. She said it’s time for adults to do the responsible thing and let the children fail. Trying something and failing, she writes, is how children learn and make discoveries about themselves and the world around them. This applies to unloading the dishwasher as well as the science fair. Becoming autonomous gives children pride in themselves and their abilities, and makes them independent thinkers and doers who can cope with the ups and downs of life.

Stop bringing forgotten homework to school, Lahey tells the parents of her students.

But it will be messy, and adults should expect as much. To Lahey’s credit, The Gift of Failure defiantly rejects the binary choices of either “triumphant or bumbling adulthood” as end goals, and sees growing up as a series of peaks and valleys with lots of time to figure things out in between. Instead, she offers practical advice, steeped in the latest research, on how to let kids find their own way as parents and teachers guide them, the key word being guide — not instruct, dictate, or enable. Giving kids autonomy may or may not make them a big “success,” but the research supports that it will make kids happier, less anxious and depressed, and more fulfilled to work towards agency in their own lives.

Lahey taught middle school for more than a dozen years, and said that in that period of time, she watched as kids went from cautious to take risks to too terrified to even make a move — write a sentence, for example — without considering what people might think or how it would affect their grade.

“The thing I began to notice was not the fear of an ‘F’, it was the fear of any mistake,” she said. “It’s not that students couldn’t get to a final draft, they couldn’t get even their ideas down. From a teacher’s point of view, that’s a nightmare! If they can’t take a risk, then certainly they aren’t raising their hand with an I-wanna-try-this-idea-out kind of thing.”

Many educators already know this, but what to do about it? Educators can play a crucial part in helping kids to get comfortable with failure, which Lahey calls “autonomy-supportive teaching” and goes hand-in-hand with “autonomy-supportive parenting.” She says there are ways educators can encourage parents to let go, and here are a few:

Encourage parents to think of raising a child as a long-haul job

Stop bringing forgotten homework to school, Lahey tells the parents of her students. And stop stressing over how your daughter will do on next week’s quiz: instead, focus on what your daughter can learn if she does it all herself, without nagging and pestering and pressure. If she does indeed fail the quiz, she may be forced to ask herself what went wrong, and what she could do better next time. Parenting is a long-haul job, Lahey says, and parents and teachers need to think more about what’s going to make kids happy in the long term. In the case of the quiz, the short-term goal is getting an ‘A,’ but the long-term goal of self-sufficiency eclipses that minor ‘A’ by a long shot.

“It’s so freeing!” she said. “You can stop worrying about the stupid details of the moment-to-moment junk, and start focusing on the big things. Just think about where your kid was one year ago today. They’re amazing!” Lahey said she’s not sure if adults just forget, or worry that’s not true. She suspects, though, that parents don’t see the amazing growth in kids because they aren’t given the opportunity to show it very often.

Focus on Process Instead of Product

Lahey confesses this is a tricky balance, especially since schools today are inherently — almost obsessively — focused on product (and may inadvertently be contributing to parents’ anxieties over academic success). But there are ways to get around that, she says.

Adjust expectations (and grades) to make room for real student work. In the book, Lahey asks a kindergarten teacher what her kids can do that their parents don’t think they can. She responds: “Everything!” In autonomy-supportive teaching, work that students plan and orchestrate themselves will look like — well, like a kid did it. That means no more science projects worthy of their own Nobel. “Teachers need to move their expectations as well. Our lines for where grades should be have creeped up anyway, based on our expectations for what the product should look like. Our expectations have been skewed by the work of the parents.”

Lahey knows that teachers love to hear that a parent has decided to make the child more responsible for his own learning: “If you tell your teacher you’re making the move to more autonomy-supportive parenting, and to please hold your child to consequences without letting the kid off the hook? If you ask the teacher to help you through this — that this is the only way your child is going to learn? Just knowing when a parent is interested in supporting a student’s voice and ability to speak up for themselves: a teacher will kiss you on the lips for that!”

Back Away From the Parent Portal

One of the biggest pitfalls to autonomy-supportive parenting, Lahey says, are the parent portal websites, with access to up-to-the-minute feedback about scores and grades. Lahey and her husband decided to forgo the parent portal for their older child. They handed the password over to their son, telling him he’d need to let them know if he was in academic trouble. Some of her friends were shocked, “as if we were defaulting on our parental duty,” she writes. “I disagree. Checking in on children’s grades is a type of surveillance, which is one of the forms of control and is often mentioned in the research as an enemy of autonomy and intrinsic motivation.”

For parents who decide to forego the parent portal (or only check it occasionally), Lahey recommends sending a note to teachers about the decision, explaining that your student is now responsible for her own communication information.

Consider the Fear of Failure May Affect More Kids Than You Think

Some educators have called out the rash of overparenting books as only written for a few upper-class parents; some have called The Overstressed American Child “a myth.” Many students are well-acquainted with failure, both their own personal shortcomings as well as the systemic failures of their schools and homes. While Lahey openly admits that The Gift of Failure doesn’t apply to everyone, she cautions that it’s not just the 1% who are terrified of their kids failing: “What I did find out by talking to teachers, is that it’s far more pervasive than we thought,” Lahey said. “We’re talking about a big chunk, a lot of middle class kids are getting the same kind of pressure,” as kids at the top. Many times, she said, the pressure’s even greater if a family doesn’t have the means to pay for college — especially when it comes to sports and scholarships.

Fear of failure destroys the love of learning

In chapter 2, Lahey relates the story of one of her students, capable and intelligent Marianna, who has “sacrificed her natural curiosity and and love of learning at the altar of achievement, and it’s our fault.”

We taught her that her potential is tied to her intellect, and her intellect is more important than her character. We taught her to protect her academic and extracurricular perfection at all costs and that it’s better to quit when things get challenging rather than risk marring that perfection.

Above all else, we have taught her to fear failure, and that fear has destroyed her love of learning.

And this is the real shame: fear of failure taints the waters of learning, keeping kids from taking risks. Making failure normal — even celebrated — Lahey contends, may be uncomfortable in the short-term, but in the long haul makes for happier, more confident kids.

Explaining The News to Our Kids

Kids get their news from many sources, which are not always correct. How to talk about the news — and listen, too.

Caroline Knorr Parenting Editor | Mom of one

Parenting Editor | Mom of one

Shootings, terrorist attacks, natural disasters, end-of-the-world predictions — even local news reports of missing kids and area shootings all can be upsetting news for adults, not to mention kids. In our 24/7 news world, it’s become nearly impossible to shield kids from distressing current events.

Today, kids get news from everywhere. This constant stream of information shows up in shareable videos, posts, blogs, feeds, and alerts. And since much of this content comes from sites that are designed for adult audiences, what your kids see, hear, or read might not always be age-appropriate. Making things even more challenging is the fact that many kids are getting this information directly on their phones and laptops. Often parents aren’t around to immediately help their kids make sense of horrendous situations.

The bottom line is that young kids simply don’t have the ability to understand news events in context, much less know whether or not a source of information is credible. And though older teens are better able to understand current events, even they face challenges when it comes to sifting fact from opinion — or misinformation.

No matter how old your kids are, threatening or upsetting news can affect them emotionally. Many can feel worried, frightened, angry, or even guilty. And these anxious feelings can last long after the news event is over. So what can you do as a parent to help your kids deal with all this information?

Tips for all kids

Consider your own reactions. Your kids will look to the way you handle the news to determine their own approach. If you stay calm and rational, they will, too.

Tips for kids under 7

Keep the news away. Turn off the TV and radio news at the top of the hour and half hour. Read the newspaper out of range of young eyes that can be frightened by the pictures (kids may respond strongly to pictures of other kids in jeopardy). Preschool kids don’t need to see or hear about something that will only scare them silly, especially because they can easily confuse facts with fantasies or fears.

Stress that your family is safe. At this age, kids are most concerned with your safety and separation from you. Try not to minimize or discount their concerns and fears, but reassure them by explaining all the protective measures that exist to keep them safe. If the news event happened far away, you can use the distance to reassure kids. For kids who live in areas where crime and violence is a very real threat, any news account of violence may trigger extra fear. If that happens, share a few age-appropriate tips for staying and feeling safe (being with an adult, keeping away from any police activity).

Be together. Though it’s important to listen and not belittle their fears, distraction and physical comfort can go a long way. Snuggling up and watching something cheery or doing something fun together may be more effective than logical explanations about probabilities.

Tips for kids 8–12

Carefully consider your child’s maturity and temperament. Many kids can handle a discussion of threatening events, but if your kids tend toward the sensitive side, be sure to keep them away from the TV news; repetitive images and stories can make dangers appear greater, more prevalent, and closer to home.

Be available for questions and conversation. At this age, many kids will see the morality of events in stark black-and-white terms and are in the process of developing their moral beliefs. You may have to explain the basics of prejudice, bias, and civil and religious strife. But be careful about making generalizations, since kids will take what you say to the bank. This is a good time to ask them what they know, since they’ll probably have gotten their information from friends, and you may have to correct facts.

Talk about — and filter — news coverage. You might explain that even news programs compete for viewers, which sometimes affects content decisions. If you let your kids use the Internet, go online with them. Some of the pictures posted are simply grisly. Monitor where your kids are going, and set your URLs to open to non-news-based portals.

Tips for teens

Check in. Since, in many instances, teens will have absorbed the news independently of you, talking with them can offer great insights into their developing politics and their senses of justice and morality. It will also give you the opportunity to throw your own insights into the mix (just don’t dismiss theirs, since that will shut down the conversation immediately).

Let teens express themselves. Many teens will feel passionately about events and may even personalize them if someone they know has been directly affected. They’ll also probably be aware that their own lives could be affected by violence. Try to address their concerns without dismissing or minimizing them. If you disagree with media portrayals, explain why so your teens can separate the mediums through which they absorb news from the messages conveyed.

Additional resources

For more information on how to talk to your kids about a recent tragedy, please visit the National Association of School Psychologists or the American Psychological Association.

Marie-Louise Mares, Associate Professor in the Department of Communication Arts at the University of Wisconsin-Madison, contributed to this article.