Parents and the New Concussion Paradigm

May 19, 2015 by
By Chris Snoddy MA, LAT ATC

Parents are more educated, more concerned and more aware of the dangers of concussions than ever before. How we communicate with parents or guardians of our concussed athletes has entered a new paradigm. This new model of communication requires documentation and more importantly, understanding. How we ensure parents understand what has happened to their child’s brain is the ultimate goal of the athletic trainer and physician.

According to Mom’s Team, 49 states and the District of Columbia “have requirement of the model Zackery Lystedt law in that parents and guardians are required them to sign a concussion information form as a condition of participation.”

When you search online about what parents need to know about concussions, you get 935,000 hits. There is a lot of concussion information on the web. With that much information available, some of it may be misinformation. The Archives of Diseases in Childhood reported “less than 40 percent of the health information searched was judged to be correct and consistent with published recommendations. Eleven percent of sites in this sample of 100 websites gave incorrect information.”  The vast amount of concussion information available is overwhelming, creating both an information overload that leads to stressed parents. 

Every month there is a national media article or network news feature the parents see. They can’t help being reminded of the perils and dangers of something that once was erroneously  considered a minor injury.  Fortunately the days of "You can go back to as soon as your headache goes away" are gone. This has created a new paradigm of educating parents about concussions and even helmets. 

According to the medical education website SayAH!, “Don’t overestimate your patient’s understanding of the health and medical information you have imparted in a visit. Studies show that patients forget up to 80 percent of what their doctor tells them as soon as they leave the office, and nearly 50 percent of what they do remember is recalled incorrectly.”

 SayAh! suggests that these strategies will help ensure that your patient knows what he or she needs to know:
  • Discuss no more than 3-5 health/medical concepts with your patient. Any more can dilute the main messages.
  • Repeat critical information, and then repeat it again.
  • Offer paper and pen to encourage the patient to take notes.
  • Write down key points and instructions for your patient. (It is handy to have these notes in duplicate - one for the patient to take home, and one to be kept in the patient’s records).
  • Use the “Teach Back” method at the end of each concept.
Over the last 3 years I have had the opportunity to interact with the parents of 34 concussed children. The Steven Covey quote comes to mind: “Most people do not listen with the intent to understand; they listen with the intent to reply.” “Seek first to understand, then to be understood.” Listening is vital in dealing with parents. Seek to understand your parent’s concerns. Of those 34 parents, four stand out. These four parents all had different concerns.

One parent had a 30 minute meeting with the athletic trainer about the school’s concussion management and testing policy before they enrolled their child. She had many good questions. She was a very informed non-medical professional who had spent much time learning about concussions. She had numerous questions about the school's return-to-play policy and who makes the final decision. I was impressed with her in-depth questions and ultimate concern for her athletic child.

Another parent who was active military had many questions about long term effects after his son’s concussion. His major concern was based on the after effects from multiple concussions. His background provided yet another viewpoint from working with people who had had multiple concussions from bomb blasts while serving overseas.

The third parent was a physician. He understood concussions well. He was concerned about the headgear used to protect his child. His concern was understandable. We had a great visit, and he became more knowledgeable about helmets and helmet testing. 

The real challenge can be dealing with the fourth parent – the one who is in denial or doesn't understand concussions. When the parent says, "I saw the hit and it was not big, so there is no way he/she got a concussion," he/she may be in denial that their child now cannot play or may have little understanding of concussions. Often this parent may be the most challenging. This parent needs to be assured that his/her child has a concussion and why it is believed they have one. The ability to share the athlete’s neurocognitive and balance test results with deficits in scores usually proves the point. The parent, when informed about what to look for, often picks up on mental changes and other key factors in his/her child.

The best time is to explain concussions to parents is before their son or daughter sustains one. A school’s athletic trainer and/or team physician should be on the program for every sports parent’s meeting yearly.  The talk should cover state laws, high school association rules and the school's concussion management plan. Being proactive is always better than reactive. Get the jump on concussion education with your parents in the preseason.
Common questions parents want to know about their concussed child:
  1. Will my child be okay and when?
  2. Who are the athletic trainers are at the school? How do I contact them? What is the role of this medical professional?
  3. Who is the team physician for my child’s school and how to we contact him/her?
  4. What resources do you recommend as an athletic trainer when my child has a concussion?  
  5. What should be expected with my child who has now suffered a mild traumatic brain injury?
  6. What are the danger signs?
  7. When should I take my child to the emergency room?
  8. Is the school's concussions management plan on the school website?
  9. How do you follow up with concussed athletes later that day or over the weekend?
  10. Who at the school handles the return to learn program for their child?
  11. How easy is it for a parent or physician to find the required return-to-play form?
  12. What is the schedule for post-concussion testing? Will it be at the school or at the physician’s office?

It's often said, "They don’t care how much you know till they know how much you care." Building rapport and seeking understanding is the key with today’s parents.

About the Author: Chris Snoddy has been an athletic trainer caring for athletes on the sidelines of Nashville’s high schools for parts of four decades. He is a past two-term president of the Tennessee Athletic Trainers Society where he was instrumental in creating Tennessee Concussion Law to protect all athletes under the age of 18. He has been inducted into two Halls of Fame as an athletic trainer. He currently is the District Nine representative on the NATA Secondary School Athletic Trainers' Committee. At STAR Physical Therapy he is in a mentorship role working with 16 other athletic trainers covering 16 high schools and daily helping the athletes at Goodpasture Christian School. Contact Chris at