The nation's most sweeping measure addressing youth-concussions in sports was signed into law Tuesday in Colorado, where the guidelines for protecting child athletes will require coaches to bench players as young as 11 when it's believed they've suffered a head injury.
The new law also requires coaches in public and private schools and even volunteer Little League and Pop Warner football coaches to take free annual training online to recognize the symptoms of a concussion. Most of the dozen other states with laws meant to protect young athletes only require concussion training for school-related athletic programs.
"This is the most far-reaching bill in the country with regard to protecting children," said Republican state Sen. Nancy Spence, one of the sponsors of the legislation.
The Colorado law, which goes into effect in January, comes as concern over concussions in youth sports is receiving more attention nationally, and it was among those passed in the last two years with support from the NFL, which either helped states craft legislation or gave endorsements for the measures.
Jeff Miller, the NFL's senior vice president for public policy, said the league is changing its culture surrounding concussions and how players are treated as new information emerges about the risks and consequence of head injuries. Miller said he understands sports at all levels look to the NFL for guidance.
"We have a responsibility to set the standard and we take that responsibility seriously," he said.
Colorado's Senate Bill 40 is named after Jake Snakenberg, a Colorado high school student who died in 2004 after being hit during a football game. His family said doctors told him his injury was likely compounded by a concussion he suffered in a previous game that went undiagnosed. Snakenberg's mother, Kelli Jantz, closed her eyes as she hugged Gov. John Hickenlooper shortly after he signed the bill into law Tuesday.
"To have Senate Bill 40, the Jake Snakenberg Act, serve as his legacy gives me some peace and provides some sense of purpose to our loss," she said.
Connecticut, Idaho, Maine, Massachusetts, New Jersey, and Oregon are among the states that have passed laws that address head injuries in youth sports, according to the National Conference of State Legislatures. Utah signed a bill into law last week and California and Nebraska are among states with pending legislation.
About 135,000 children ages 5 to 18 are treated in emergency rooms annually for sports and recreation related concussions, according to the U.S. Centers for Disease Control and Prevention.
"For me, because the child's brain is still development, is still immature, I think we need to take these injuries especially seriously," said Dr. Michael Kirkwood, a pediatric neuropsychologist at the Children's Hospital and co-director of the hospital's concussion program. Kirkwood said another reason to pay attention to brain injuries in youth sports is that there is little information about the long-term impacts concussions have on young athletes. Most of the information doctors know about the consequences of concussions, including mood and cognitive disorders, come from the NFL.
"We don't have an answer yet for younger kids," Kirkwood said.
Jake Bryant, 16, was a goalie in an advanced youth hockey with the Colorado Rampage when he decided to retire after suffering five concussions in less than two years.
"I just kept getting more and more and it was to the point where it was too much it was risking my health," he said. Bryant said he feels fortunate that he did not suffer more serious harm because he and his coaches handled his injuries correctly because he was never pressured to stay in a game or return prematurely.
Another youth hockey player, Alexandra "Z" Karlis, suffered her first concussion last October while playing in Boston with a Colorado youth hockey team. Karlis, 17, will continue to play, but she said the injury made her aware of all the potential long-term impacts of concussions.
"That completely freaked me out," she said.
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