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.

Read, Kids, Read

The New York Times

As an uncle I’m inconsistent about too many things.

Birthdays, for example. My nephew Mark had one on Sunday, and I didn’t remember — and send a text — until 10 p.m., by which point he was asleep.

School productions, too. I saw my niece Bella in “Seussical: The Musical” but missed “The Wiz.” She played Toto, a feat of trans-species transmogrification that not even Meryl, with all of her accents, has pulled off.

But about books, I’m steady. Relentless. I’m incessantly asking my nephews and nieces what they’re reading and why they’re not reading more. I’m reliably hurling novels at them, and also at friends’ kids. I may well be responsible for 10 percent of all sales of “The Fault in Our Stars,” a teenage love story to be released as a movie next month. Never have I spent money with fewer regrets, because I believe in reading — not just in its power to transport but in its power to transform.

So I was crestfallen on Monday, when a new report by Common Sense Media came out. It showed that 30 years ago, only 8 percent of 13-year-olds and 9 percent of 17-year-olds said that they “hardly ever” or never read for pleasure. Today, 22 percent of 13-year-olds and 27 percent of 17-year-olds say that. Fewer than 20 percent of 17-year-olds now read for pleasure “almost every day.” Back in 1984, 31 percent did. What a marked and depressing change.

I know, I know: This sounds like a fogy’s crotchety lament. Or, worse, like self-interest. Professional writers arguing for vigorous reading are dinosaurs begging for a last breath. We’re panhandlers with a better vocabulary.

But I’m coming at this differently, as someone persuaded that reading does things — to the brain, heart and spirit — that movies, television, video games and the rest of it cannot.

There’s research on this, and it’s cited in a recent article in The Guardian by Dan Hurley, who wrote that after “three years interviewing psychologists and neuroscientists around the world,” he’d concluded that “reading and intelligence have a relationship so close as to be symbiotic.”

In terms of smarts and success, is reading causative or merely correlated? Which comes first, “The Hardy Boys” or the hardy mind? That’s difficult to unravel, but several studies have suggested that people who read fiction, reveling in its analysis of character and motivation, are more adept at reading people, too: at sizing up the social whirl around them. They’re more empathetic. God knows we need that.

Late last year, neuroscientists at Emory University reported enhanced neural activity in people who’d been given a regular course of daily reading, which seemed to jog the brain: to raise its game, if you will.

Some experts have doubts about that experiment’s methodology, but I’m struck by how its findings track something that my friends and I often discuss. If we spend our last hours or minutes of the night reading rather than watching television, we wake the next morning with thoughts less jumbled, moods less jangled. Reading has bequeathed what meditation promises. It has smoothed and focused us.

Maybe that’s about the quiet of reading, the pace of it. At Success Academy Charter Schools in New York City, whose students significantly outperform most peers statewide, the youngest kids all learn and play chess, in part because it hones “the ability to focus and concentrate,” said Sean O’Hanlon, who supervises the program. Doesn’t reading do the same?

Daniel Willingham, a psychology professor at the University of Virginia, framed it as a potentially crucial corrective to the rapid metabolism and sensory overload of digital technology. He told me that it can demonstrate to kids that there’s payoff in “doing something taxing, in delayed gratification.” A new book of his, “Raising Kids Who Read,” will be published later this year.

Before talking with him, I arranged a conference call with David Levithanand Amanda Maciel. Both have written fiction in the young adult genre, whose current robustness is cause to rejoice, and they rightly noted that the intensity of the connection that a person feels to a favorite novel, with which he or she spends eight or 10 or 20 hours, is unlike any response to a movie.

That observation brought to mind a moment in “The Fault in Our Stars” when one of the protagonists says that sometimes, “You read a book and it fills you with this weird evangelical zeal, and you become convinced that the shattered world will never be put back together unless and until all living humans read the book.”

Books are personal, passionate. They stir emotions and spark thoughts in a manner all their own, and I’m convinced that the shattered world has less hope for repair if reading becomes an ever smaller part of it.

Are Kids Too Coddled?

The New York Times

Andy Rementer

 

By 
Published: November 23, 2013

AT a middle school near Boston not long ago, teachers and administrators noticed that children would frequently return from a classmate’s weekend bar mitzvah with commemorative T-shirts, swag that advertised a party to which many fellow students hadn’t been invited.  So administrators moved to ban the clothing.

They explained, in a letter to parents, that “while the students wearing the labeled clothing are all chatting excitedly,” the students without it “tend to walk by, trying not to take notice.” What an ordeal.

Many parents favored the ban, a prophylactic against disappointment.

Some did not, noting that life would soon enough deal the kids much worse blows along these lines. And one observer, in a Facebook thread, said this, according to a local TV station’s report: “Perhaps they should dress the children in Bubble Wrap and tie mattresses to their backs so they don’t get hurt.”

I assume that’s facetious.

But these days, you never know.

I occasionally flash on that anecdote as I behold the pushback against more rigorous education standards in general and the new Common Core curriculum in particular. And it came to mind when Education Secretary Arne Duncan recently got himself into a big mess.

Duncan, defending the Common Core at an education conference, identified some of its most impassioned opponents as “white suburban moms” who were suddenly learning that “their child isn’t as brilliant as they thought they were, and their school isn’t quite as good.”

It was an impolitic bit of profiling. Gratuitous, too. But if you follow the fevered lamentations over the Common Core, look hard at some of the complaints from parents and teachers, and factor in the modern cult of self-esteem, you can guess what set Duncan off: a concern, wholly justified, that tougher instruction not be rejected simply because it makes children feel inadequate, and that the impulse to coddle kids not eclipse the imperative to challenge them.

The Common Core, a laudable set of guidelines that emphasize analytical thinking over rote memorization, has been adopted in more than 40 states. In instances its implementation has been flawed, and its accompanying emphasis on testing certainly warrants debate.

What’s not warranted is the welling hysteria: from right-wing alarmists, who hallucinate a federal takeover of education and the indoctrination of a next generation of government-loving liberals; from left-wing paranoiacs, who imagine some conspiracy to ultimately privatize education and create a new frontier of profits for money-mad plutocrats.

Then there’s the outcry, equally reflective of the times, from adults who assert that kids aren’t enjoying school as much; feel a level of stress that they shouldn’t have to; are being judged too narrowly; and doubt their own mettle.

Aren’t aspects of school supposed to be relatively mirthless? Isn’t stress an acceptable byproduct of reaching higher and digging deeper? Aren’t certain fixed judgments inevitable? And isn’t mettle established through hard work?

Apparently not, to judge from some reactions to the Common Core in New York, which has been holding hearings on the guidelines.

One father said that while his 8-year-old son was “not the most book-smart kid,” he was nonetheless “extremely bright.” With the new instruction, however, too many kids were “being made to feel dumb.” There was “no room for imagination or play,” the father groused. “All the kids are stressed out.”

A SOCIAL WORKER testified that she’d been receiving calls and referrals regarding elementary-school students on the psychological skids. “They said they felt ‘stupid’ and school was ‘too hard,’ ” she related. “They were throwing tantrums, begging to stay home and upset even to the point of vomiting.” Additional cases included insomnia, suicidal thoughts and self-mutilation, she said, and she wondered aloud if this could all be attributed to the Common Core.

A teacher on Long Island did more than wonder, speaking out at a forum two weeks ago about what she called the Common Core Syndrome, a darkly blooming anxiety among students that’s “directly related to work that they do in the classroom.”

“If that’s not child abuse, I don’t know what is,” she thundered, to wild applause. Then she endorsed the idea of parents’ exempting kids from Common Core-related tests. “The mommies in New York,” she concluded, “don’t abuse their children.”

If children are unraveling to this extent, it’s a grave problem. But before we beat a hasty retreat from potentially crucial education reforms, we need to ask ourselves how much panic is trickling down to kids from their parents and whether we’re paying the price of having insulated kids from blows to their egos and from the realization that not everyone’s a winner in every activity on every day.

There are sports teams and leagues in which no kid is allowed too much more playing time than another and in which excessive victory margins are outlawed. Losing is looked upon as pure trauma, to be doled out gingerly. After one Texas high school football team beat another last month by a lopsided score of 91-0, the parent of a losing player filed a formal complaint of bullying against the winning team’s coach.

It used to be that trophies went to victors; now, in many leagues, they go to everybody — for participation. Some teams no longer have one or two captains, elected by the other players, but a rotating cast, so that nobody’s left out.

Some high schools have 10, 20 or 30 valedictorians, along with bloated honor rolls and a surfeit of graduation prizes. Many kids at all grade levels are Bubble-Wrapped in a culture that praises effort nearly as much as it does accomplishment.

And praise itself is promiscuous, though there are experts with profound reservations about that approach. They say it can lessen motivation and set children up to be demoralized when they invariably fail at something.

“Our students have an inflated sense of their academic prowess,” wrote Marc Tucker, the president of the National Center on Education and the Economy, in Education Week. “They don’t expect to spend much time studying, but they confidently expect good grades and marketable degrees.”

David Coleman, one of the principal architects of the Common Core, told me that he’s all for self-esteem, but that rigorous standards “redefine self-esteem as something achieved through hard work.”

“Students will not enjoy every step of it,” he added. But if it takes them somewhere big and real, they’ll discover a satisfaction that redeems the sweat.

And they’ll be ready to compete globally, an ability that too much worry over their egos could hinder. As Tucker observed, “While American parents are pulling their kids out of tests because the results make the kids feel bad, parents in other countries are looking at the results and asking themselves how they can help their children do better.”

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