Board of Ed Discusses Implementing ImPACT Tests

In a comprehensive presentation made before the Board of Education earlier this month, school physician Joelle Rehberg and athletic trainer Don Heyburn gave an in-depth explanation of the ImPACT test that aids in analyzing the affects of a concussion on student-athletes.

The test is part of a policy to ensure the safe return of Montville student-athletes to the field after suffering head injuries.

Rehberg began the explanation, giving the basic parameter of ImPACT, which stands for Immediate Post-Concussion Assesment Cognitive Test. The test is research computer-based and helps in evaluating an athlete's recovery objectively by assigning them a baseline score prior to injury and then monitoring symptoms in relation to distance below their baseline score.

Rehberg made it clear, however, that ImPACT was not a complete replacement for the intuition of trainers and physicians.

"ImPACT is just a tool we use," Rehberg said. "It's not the end all be all when it comes to determining whether these students can get back to play."

Among many aspects of a player's cognition and wellness ImPACT uses neurocognitive testing to measure attention time and reaction time using patterns of Xs and Os that players must identify. Reaction time is a factor to which test gives particular attention.

"We will not put a football player back if reaction time is slow," Rehberg said. "If he can't protect himself and isn't strong enough to protect himself we are aware."

Both Rehberg and Hayburn share first-hand knowledge of the ImPACT testing.

"I took the course as Don has and we are both ImPACT certified so that adds to it," Rehberg said.

According to Rehberg, the test should be administered to atheletes before the sports season even starts. Rehberg and Hayburn have pushed to put it into the policy that baseline testing be mandatory for athletes every two years, as in their freshman and juinor years, or after an injury.

Students who have suffered and injury should be tested within 72 hours of the injury and periodically every two weeks or depending on how often a student has symptoms.

Normative data concerning age or gender is also consulted in seeking a student's baseline score. Dr. Rehberg sees this as often unreliable at times for students whose GPA's fall below the average for their age and gender.

"If you have a C grade student he won't be up in the 89th percentile," Dr. Rehberg said. "We would have to look at whether his grades tend to be trending the same as his usual."

Rehberg also brought up the concern of athletes intentionally scoring low baseline scores so that they can more easily meet that score after suffering a concussion and return more quickly to the field.

"In August when Don sits them all down together a couple of kids say 'I'm going to dumb it up now so that when I get concussed my baseline is lower," Rehberg said. "They do it, they really do."

Following the presentation, Board of Education President Dr. Karen Cortellino asked about possible conflicts between the the school physician's opinion of a student's injury and that of the student's private physician.

"It happens quite a bit actually," Hayburn said. "What We've built into our new policy is that Dr. Rehberg has the last say as to whether or not the athlete has a concussion or not. When a doctor will say 'I don't really feel the athlete has a concussion.' but that gives me the opportunity to tell them that I examined them right after the injury and this is what I found."

Communications Chairman Paul Przetak asked if a student concussed in his freshman year should be tested again before their sophomore year.

"There should be no need to because if you have his baseline then that's his baseline and they're not going to return to play until they've approached their baseline score. The only reason they do [the test] in between the freshman and junior year is because of the education change."