Headed for Trouble

BU scientists are renowned for their research on concussions suffered by NFL veterans. Now their studies are raising alarming questions about the true dangers of high school football.

Perhaps the easiest — and cheapest — step for schools to take is to implement neurocognitive testing: memory and reflex exercises designed to show whether an athlete has suffered from a concussion. The most popular version is called the ImPACT test. It costs between $500 and $1,000 per year per school district, according to neuropsychologist Neal McGrath, who runs Sports Concussion New England, a clinic and consultancy in Brookline that helps some schools administer the test. It works simply enough: The healthy player takes it at the beginning of the season to serve as a baseline.

Then, if the athlete takes a big knock to the head, he or she can be retested. If the results are significantly worse, it’s likely a concussion. When testing levels return to normal, the athlete is ready to get back on the field. Because concussions may not show up in X-rays or CAT scans, ImPACT is viewed as a valuable tool for diagnosis. Nurses or school trainers can administer it, and its results show overly insistent players that they shouldn’t return to play so quickly. Despite ImPACT testing’s relatively low cost, however, only about 90 of the state’s more than 500 public and private high schools utilize it. (Boston is not one of them.)

McGrath and Nowinski caution that concussions are just as likely to happen in practice as they are in games. “The trainers at the high school level have 20 sports to cover,” says Nowinski. “So they’re not at practice.”

McGrath, who treats around 500 kids per year, says that there’s a huge gap between how well small private schools monitor and treat concussions and how well public schools do — even the wealthiest public schools. It’s a simple numbers game. For instance, Noble and Greenough, the Dedham private school, has two athletic trainers watching over nearly 600 students full time. Compare that with a school like Needham High, which has just one athletic trainer to care for more than 1,400 students. “The closer the athletic trainers are able to watch the kids, the more injuries we seem to get reported to us,” McGrath says.

Even when schools have the resources, though, there’s not always demand for them. Thanks to Boston Latin’s Longwood location and generous alumni, the school’s longtime football coach and athletic director, John McDonough, is able to staff an athletic trainer during both games and practices. Last spring, though, when McDonough arranged for ImPACT testing at Children’s Hospital — working independently from the school district — just 65 to 70 of his school’s 300 athletes paid the $20 to have it done. “Come on, let’s do this,” he vents. “I certainly wouldn’t single out individuals, but there were a couple of our athletes who had suffered multiple concussions, and they weren’t tested.”