NEW CASTLE — A Lawrence County woman has taken the lead in helping Pennsylvania school personnel evaluate and assist students with concussions.

Brenda Eagan Brown, a Laurel High School graduate, is the state coordinator for BrainSTEPS, a program that unveiled “Concussion Return to School Protocol” with the state Department of Education. She enhanced the system by creating school-based academic Concussion Management Teams.

“We are the first state to do anything so systematically and on such a large scale,” she said.

Some 149 of Pennsylvania’s 501 schools districts have responded, including five in Lawrence County. “I thought if we set up 50 teams, it would be great, but we ended up with 360,” Brown said.

Wilmington and Ellwood City have four concussion management teams each while Shenango has three. Union and the Lawrence County Career and Technical Center have one each.

“It’s great to see local schools involved,” said Brown, a graduate of Laurel High School. “We saw a need for returning to school issues that weren’t just focussed on returning to sports.”

CMTs will support students returning to the demands of school while promoting recovery. They will partner with BrainSTEPS consulting teams that span the state, based in the educational intermediate units. The BrainSTEPS infrastructure is available to schools as a second layer of more intensive student concussion support, consultation and training, for students who do not recover in the typical four week trajectory.

CMT training was held at 25 sites across the Commonwealth.

Each CMT is made up of three persons, headed by a supervisor, usually a superintendent, principal or special education director. There are two monitors — one academic, usually a school psychologist or guidance counselor; and a symptom monitor, usually a school nurse. They agree to manage student recovery for the initial four weeks.



TAKING CHARGE

Julie Hudak, a school nurse for the past eight years, is part of the CMTs at Shenango. She said the number of concussions in the school system each years numbers from a few to a half dozen.

Joe McCormick, principal Shenango High School, endorses the program.

“Because research is catching up and the medical field is learning a lot more about how to help kids heal,” he said. “We’re making academic accomodations, allowing concussed students to come back to school a few hours at a time until they are able to to attend a full day.”

Dave Nerti, principal at Union High School, attended the recent CMT session along with a school nurse and school psychologist.

Nerti said Union teachers are on board with the protocol. “Many of them have dealt with concussions and they understand.”

Nerti knows about the dangers first hand, having suffered sports-related concussions in high school and college. “I was still dazed when I went back to school,” he said.

He said there is a need to monitor concussed students and determine their capabilities.



CAUSES

Approximately 22,000 child and adolescent concussions, which are defined as traumatic brain injuries, occur each year in Pennsylvania.

Brown said about half of those are attributed to participation in sporting events with the remainder coming from other activities or incidents, primarily automobile accidents.

Current research shows that 80 percent of students will recover in the first four weeks after a concussion.

Brown said returning to the full demands of school must be carefully managed, because returning to a full academic load too soon following a concussion can significantly increase and prolong symptoms.  

Brown contends some concussed students were coming back to school too soon. “Hundreds of students across state were referred to us because they weren’t getting better,” she said.

There was a need in schools to easily access tools so educational professionals could accurately monitor symptoms and academics,” Brown said. “These areas are key to managing student concussion ‘symptom thresholds’ at school, while ensuring that learning is still taking place.

“We don’t want students to experience symptoms caused by cognitively fatiguing the brain while it is trying to heal.”

At four weeks, if symptoms persist, a referral for more intensive support is made to the BrainSTEPS program.  



ONE TREATMENT FOR ALL

“The severity of the concussion doesn’t matter, according to Brown. “They all need to be treated the same.”

“They’ve done away with grading of concussions because when kids and their parents would hear they had a grade 1 concussion, they would think it was minor and try go back to full activity.”

Brown said all concussions should be treated the same.

Brown said without the proper protocol, symptoms are likely to linger, especially if the patient has concussion modifiers, which include a history of migraines, attention problems, sleep problems, depression or other mental health conditions and prior concussions.

Students normally stay home from school from one to three days following a concussion. Brown said concussed students should not return until they can focus for 30 minutes without getting any symptoms. The CMT protocol calls for rest breaks of 10 minutes after every 30 minutes of study.

“We know if students go back to school without accommodations, it will take longer to recover.”

Brown, who graduated from Wittenburg University in Springfield, Ohio, has a degree in special education and elementary education. She has a master’s degree from George Washington University in traumatic injuries.

Her interest in dealing with the subject began years ago when her brother sustained a severe traumatic brain injury after being struck by a car. After that, she began volunteering in Harrisburg, helping to create BrainSTEPS.

“It sparked my interest,” she said. “After I saw what my family went through, there was nothing for kids for brain injuries.”

(Email: d_burcham@ncnewsonline.com)