Head Games An SLP in Texas helped change a community’s rules of football—and other contact sports—to protect young children from traumatic brain injury. In the Limelight
In the Limelight  |   October 01, 2016
Head Games
Author Notes
  • Shelley D. Hutchins is content producer/editor for The ASHA Leader. shutchins@asha.org
    Shelley D. Hutchins is content producer/editor for The ASHA Leader. shutchins@asha.org×
Article Information
Attention, Memory & Executive Functions / Traumatic Brain Injury / In the Limelight
In the Limelight   |   October 01, 2016
Head Games
The ASHA Leader, October 2016, Vol. 21, 26-27. doi:10.1044/leader.LML.21102016.26
The ASHA Leader, October 2016, Vol. 21, 26-27. doi:10.1044/leader.LML.21102016.26
Name: Anthony Salvatore, PhD, CCC-SLP
Title: Chair, Department of Rehabilitation Sciences, and director, Speech Language Pathology Program and Concussion Management Clinic, College of Health Sciences, University of Texas at El Paso
Hometown: Santa Teresa, New Mexico
Football’s a big deal in Texas. Suffering from traumatic brain injury (TBI) as a 5-year-old is bigger. Which is why speech-language pathologist Anthony Salvatore got a call from Paula Powell, director of El Paso Parks and Recreation, last year. She wanted to talk football, TBI and how to reduce concussion risks—especially for El Paso’s Mighty Mite tackle leagues for 5- to 7-year-olds.
The call came to Salvatore because he runs a concussion management clinic at the University of Texas at El Paso (UTEP). The clinic provides services to concussion patients and offers a certificate in concussion management for students.
Salvatore originally conceived of the clinic to support military service members who had sustained concussions in overseas conflicts. As local military services were about to close, he started offering services to middle and high school athletes in the community as well as to the university’s teams.
When Salvatore started the clinic, he reached out to UTEP athletics departments, local middle and high schools, and Powell. Salvatore made these community connections because he depends on their referrals to train students to recognize and treat TBI, collect data and conduct research. The campus clinic’s concussion management certification requires students to take a course and spend around 30 hours in the clinic. Those required hours, in turn, provide the clinic enough resources to treat and track athletes with concussions.
Powell remembered Salvatore’s offer to help with community athletics programs, so she asked him to review the programs’ rules for all contact sports, including football and soccer, and make recommendations. Salvatore shared articles and information on the effects of concussion. He also cautioned the director to err on the side of extreme protection, because not much research has tracked the long-term effects of TBI in children.
“Paula Powell and I talked about a number of options on how to improve the safety of these kids,” says Salvatore. “Data are just beginning to get collected, so we needed to be really conservative—especially with young children.”
One of the biggest changes they implemented to existing parks and rec league rules is eliminating tackle football and soccer headers—hitting the ball with your head—for the 5- to 7-year-old teams. Salvatore advised on other rules and guidelines, such as providing concussion training for coaches and parents, limiting games played to one a week per player, reducing the number of days when coaches allow hitting during practice, and not scheduling city league games on the same day as school games—for players who play in both leagues. In addition, players participating in city leagues can’t join other leagues at the same time.

“We talked about a number of options on how to improve the safety of these kids. Data are just beginning to get collected, so we needed to be really conservative—especially with young children.”

Salvatore took several graduate students in the concussion management program to the city council vote on implementing these new rules. They offered support for Powell’s proposition in the form of research on the effect of concussions on young children’s brain development. However, Salvatore says many more studies and data collections are needed. To help, he plans to track the influence of these rule changes, which took effect in time for the 2015 fall football season.
“Turns out the parks and rec department collects injury data and has 20 years of it archived,” Salvatore says. He’ll compare the past data to injuries recorded over the next few years to determine how the new rules work to prevent concussions. In addition, he conducted several education sessions on head safety and TBI prevention for area parents, coaches, trainers and physicians.
Salvatore also talks to school-based SLPs to enlist their help. Too often, children with concussions don’t see a physician, says Salvatore, but most schools have an SLP on staff. He understands school SLPs’ concerns about caring for concussed students as potentially overwhelming to already-busy caseloads, so he points out these students won’t be on SLPs’ schedules for long.
Salvatore has also worked with his student clinicians to devise a short, simple TBI evaluation for school-based SLPs. The test doesn’t require fancy equipment or a lot of time, Salvatore explains, and focuses on techniques they already know. His hopes to see SLPs included on concussion-management teams in schools. Salvatore believes enlisting school-based SLPs, educators, community leaders, coaches and parents to change sports behavior and attitudes will help promote concussion prevention.
“We’re optimistic these rule changes and training sessions will really matter,” Salvatore says. “If we can demonstrate their effect, I think people around the country will follow the El Paso Parks and Recreation Department’s lead.”
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October 2016
Volume 21, Issue 10