1. Lucas Bauer1, Morgan Mitchell1, Lexi Berry1, Ashley Hiatt1, Bethany Doom1, Zach Woods2, Jeffry Grassmeyer1,
Holly Showalter, Ph.D.1 1 Waukee APEX, Waukee High School, Waukee, IA; 2 Clarke County Hospital, Osceola, IA
Abstract
Currently in today’s society there is growing
controversy over the staggering number of
concussions athletic teens receive. There have
been many national statistics about concussion
related issues, but has there been any studies in
Waukee, Iowa? This Twitter poll study was
conducted to compare and contrast the rates of
athletic teen concussion related issues from
Waukee High School to the national average. A
recent survey from Waukee High School athletic
students suggests that current concussion related
issue rates in Iowa are higher than the national
average. The average rate of concussions in
athletic high school students nationally is 20%1,
while the student reported average rate of
concussions in Waukee High School is 47.1%.
The average rate of athletic high school students
nationally hiding a concussion is 27.5% while the
average rate of athletic high school students in
Waukee High School hiding their concussion is
31.4%. In conclusion, there are statistically
higher rates of concussion related issues in
Waukee than the national average. This matters
because the concussions today can affect the
health issues tomorrow.
Introduction
In the U.S., concussions have been in the media
lately and have been a hot topic with high school
sports. In the last 10 years, the CDC reported
that the amount of concussions has doubled. 1
The American Academy of Pediatrics states that
the amount of emergency room visits for kids
ranging from 8 to 13 years has doubled and the
amount of concussions from teens ranging from
14 to 19 years has increased by 200% from
1997-2007. 2 In Iowa, all athletes and parents are
required to sign a state mandated concussion
form as shown in Figure 1. We hypothesized
rates would be lower for Waukee due to better
quality equipment and more awareness with
families and students.
Figure 1. Iowa Student Concussion Form
Methods
⚫️ Waukee high school athletes were surveyed
on Twitter in Fall 2015 using a Google survey
questioning them about concussions and the
sports they participate in at Waukee High School.
⚫️ APEX collected and analyzed the data to
statistically prove that Waukee is either significant
or not significant with the data of Waukee
reported concussions compared to the National
average.
⚫️ To prove that Waukee does or does not have a
statistically significant difference in concussion
rates, we used the Z-score.
Results
Discussion
After we found the results, we decided to discuss
them with our high school football coach, Mr.
Scott Carlson. One option discussed was that
many students stated they had a concussion, but
a doctor didn't necessarily diagnose it. There
could be over-reporting in our survey because we
did not access medical records of the students to
verify results. Some concussions could be more
or less severe than others. Mr. Carlson does
want to see improvements in high school football
overall. He suggested blood tests to diagnose
concussions, improvements to the teaching of
football and the equipment as possibilities. Mr.
Carlson wanted to use a test of basic information
that they test at the beginning of the season to
see if they can answer the questions the same
way to see if they suffer from a concussion or
head trauma from a big hit.
Conclusions
In this study, our objectives were to 1) evaluate if the State
of Iowa mandated concussion form that all athletes must
sign is adequate, 2) raise awareness about concussion
related issues for high school students, and 3) advance our
professional skills. In conclusion, we were wrong with our
hypothesis and we found that concussion rates seem to be
higher in Waukee than the National average. The higher
rates could be linked to higher medical awareness and
treatment in our district. More medical based scientific
studies would need to be conducted in order to assess
these theories. In the future, we would like to compare
legislation between different state governments over athletic
high school students and have surveys in those states. Now
one question we have where do we go from here? We
would like to specifically compare high schools in Iowa and
in other states. We would like to compare the types of
legislation and the effects on it for concussion related
issues. We believe legislation is another potentially
significant factor in concussion related issues.
Acknowledgements
We would like to thank Dr. Showalter for giving us this
project and allowing us to learn more about teen concussion
related issues. We would also like to thank Bethany Doom
and Ashley Hiatt for pioneering this study with Zach Woods.
We thank Jeff Grassmeyer for teaching us about the
statistics and thank Scott Carlson for his thoughts on our
project.
References
1. "Head Case - Complete Concussion Managements."
Stats on Concussions & Sports -. Head Case, 2013. Web.
28 Mar. 2016.
2. Bakhos, L.L., Lockhart, G.R., Myers, R., Linakis, J.G.
“Emergency Department Visits for Concussion in Young
Child Athletes”, Pediatrics, 2010; 126, e550-e556.
3. Doyle, Kathryn. "High School Athletes Often Playing with
Concussions." Reuters. Thomson Reuters, 2014. Web. 28
Mar. 2016.
Teen Concussion Study:
Waukee High School Students Comparing and Contrasting the Rates of Athletic Teen
Concussion Related Issues from Waukee High School to the National Average
Figure 2
Figure 3
Reported Concussions
% Reported Concussions
(Nationally)
% Reported Concussions
(Waukee)
20% 47.1%
p <0.01 Z-Score=2.648 Waukee Test Value=5.65
Result:
Waukee Statistically Higher in
Concussions
Would Hide a Concussion
% Reported
(Nationally)
% Reported
(Waukee)
27.5% 31.4%
p <0.01 Z-Score=2.648 Waukee Test Value=0.731
Result:
Waukee Statistically Similar to
National Data
What is a concussion?
A concussion is a brain injury. Concussions are caused by a
bump, blow, or jolt to the head or body. Even a “ding,” “getting
your bell rung,” or what seems to be a mild bump or blow to the
head can be serious.
What parents/guardians should do if they think
their child has a concussion?
1. OBEY THE NEW LAW.
a. Keep your child out of participation until s/he is cleared to
return by a licensed healthcare provider.
b. Seek medical attention right away.
2. Teach your child that it’s not smart to play with a concussion.
3. Tell all of your child’s coaches and the student’s
school nurse about ANY concussion.
What are the signs and symptoms of a concussion?
You cannot see a concussion. Signs and symptoms of concussion
can show up right after the injury or may not appear or be noticed
until days after the injury. If your teen reports one or more symptoms
of concussion listed below, or if you notice the symptoms yourself,
keep your teen out of play and seek medical attention right away .
STUDENTS:
If you think you have a concussion:
• Tell your coaches & parents – Never ignore a bump or
blow to the head, even if you feel fine. Also, tell your coach if
you think one of your teammates might have a concussion.
• Get a medical check-up – A physician or other licensed
health care provider can tell you if you have a concussion, and
when it is OK to return to play.
• Give yourself time to heal – If you have a concussion,
your brain needs time to heal. While your brain is healing,
you are much more likely to have another concussion. It is
important to rest and not return to play until you get the OK
from your health care professional.
IT’S BETTER TO MISS ONE CONTEST THAN THE WHOLE SEASON.
HEADS UP: Concussion in High School Sports
A FACT SHEET FOR PARENTS AND STUDENTS
The Iowa Legislature passed a new law, effective July 1, 2011, regarding students in grades 7 – 12 who participate in
extracurricular interscholastic activities. Please note this important information from Iowa Code Section 280.13C,
Brain Injury Policies:
(1) A child must be immediately removed from participation (practice or competition) if his/her coach or a contest of ficial observes
signs, symptoms, or behaviors consistent with a concussion or brain injury in an extracurricular interscholastic activity .
(2) A child may not participate again until a licensed health care provider trained in the evaluation and management of concuss ions and
other brain injuries has evaluated him/her and the student has received written clearance from that person to return to partic ipation.
(3) Key definitions:
“Licensed health care provider” means a physician, physician assistant, chiropractor , advanced registered nurse
practitioner, nurse, physical therapist, or athletic trainer licensed by a board.
“Extracurricular interscholastic activity” means any extracurricular interscholastic activity , contest, or practice,
including sports, dance, or cheerleading.
Signs Reported by Students:
• Headache or “pressure” in head
•Nausea or vomiting
•Balance problems or dizziness
•Double or blurry vision
•Sensitivity to light or noise
•Feeling sluggish, hazy, foggy, or groggy
•Concentration or memory problems
•Confusion
•Just not “feeling right” or is “feeling down”
PARENTS:
How can you help your child prevent a concussion?
Every sport is different, but there are steps your children can take
to protect themselves from concussion and other injuries.
• Make sure they wear the right protective equipment for their
activity. It should fit properly, be well maintained, and be worn
consistently and correctly.
• Ensure that they follow their coaches’ rules for safety and the
rules of the sport.
• Encourage them to practice good sportsmanship at all times.
Signs Observed by Parents or Guardians:
• Appears dazed or stunned
•Is confused about assignment or position
•Forgets an instruction
•Is unsure of game, score, or opponent
•Moves clumsily
•Answers questions slowly
•Loses consciousness (even brie fly)
•Shows mood, behavior, or personality changes
•Can’t recall events prior to hit or fall
•Can’t recall events after hit or fall
Information on concussions provided by the Centers for Disease
Control and Prevention.
For more information visit: www.cdc.gov/Concussion
IMPORTANT: Students participating in interscholastic athletics, cheerleading and dance; and their parents/guardians; must annua lly sign the acknowl-
edgement below and return it to their school. Students cannot practice or compete in those activities until this form is signed and returned.
We have received the information provided on the concussion fact sheet titled, “HEADS UP: Concussion in High School Sports.”
Student’s Signature Date Student’s Printed Name
Parent’s/Guardian’s Signature Date Student’s Grade Student’s School
May2012-CE