Concussion Information for Referees

Concussion - Referees

Concussions in youth sports have become an important concern and AYSO takes this issue very seriously. As a coach, you play an important role in identifying and acting when an athlete exhibits the signs, symptoms, or behaviors of concussion.

However as a referee, you also play an important role in identifying and acting when an athlete exhibits the signs, symptoms, or behaviors of concussion. However, be sure to keep in mind that only a trained medical professional can diagnose when a concussion has occurred.

There are several steps referees must take to comply with AYSO policy and Ohio state law.

In order to be educated on the signs, dangers, and ways to prevent concussions, referees are:

Required to be trained in recognizing the signs and symptoms of concussions every three years by successfully completing a free online training course.

If a referee observes a player who exhibits the signs, symptoms, or behaviors of a concussion, referees are required to:

Remove the player from practice or game competition.

Prevent the player from returning to play or any sports activity the same day that he/she is removed.

Prohibit the player from participating in future practices, games, or any soccer activities until AYSO has received written clearance of return to play from a physician or other licensed heath care provider.

Referee Education and Training:

AYSO requires that all parents sign and return the Parent/Athlete Concussion information sheet at the beginning of each season. This sheet is designed to provide all parents with information about the signs and symptoms of concussions as well as what to do if your athlete experiences a concussion. You should also read this form and keep a copy of it with your team materials at all times.

AYSO CDC Concussion Handout

AYSO does not allow a player to participate in any AYSO soccer activities, including practices and games, until this form has been signed and returned. This form is part of Twinsburg AYSO’s registration materials and is typically returned when an athlete is registered for Twinsburg AYSO.

Additionally, the state of Ohio recently passed Bill 143, Ohio’s "Return to Play” Concussion law.

Per ORC 3707.52 as enacted by Ohio HB 143 of the 129th General Assembly, youth sports leagues are required to hand out a concussion and head injury information sheet created by the Ohio Department of Health (ODH) to all parents.
: Coaches will hand out this Ohio Youth Sports Organization Concussion Form to your team’s parents at the first practice. AYSO will provide you with copies of this sheet with your team roster packet. This Ohio Department of Health information sheet provides concussion information as well as the five-step process an athlete should go through to return to sports activities after a concussion.

Referees (and coaches) are also required to successfully complete a free online Concussion training program to recognize the signs and symptoms of concussions every three years.

Instructions to complete your concussion training are found here.

All referees, regardless of age, are required to complete this training in order to officiate any AYSO games. You must complete all parts of this training before your first game or scrimmage, as required by state law. AYSO tracks this training. Any referee who does not complete the concussion training course will not be allowed to officiate this year.

Furthermore, Ohio Bill 143 also protects youth sports organizations, coaches and referees from civil lawsuits that might arise under the new law.

"Sec. 3707.511 (F)(1) A youth sports organization or official, employee, or volunteer of a youth sports organization, including a coach or referee, is not liable in damages in a civil action for injury, death, or loss to person or property allegedly arising from providing services or performing duties under this section, unless the act or omission constitutes willful or wanton misconduct.”

Concussion recognition and "Return to Play”

Another major part of the new Ohio State law deals with what referees are required to do if they suspect a player may have received a concussion. This part applies to coaches as well.

If a referee (or coach) believes an athlete is exhibiting the signs, symptoms or behaviors of having sustained a concussion, they must remove that player from practice or competition.

The player is not allowed to return to play the same day that he/she is removed.

This decision may be made by a referee (or coach) without parental approval. The decision is final and there is no appeal. Ultimately, the athlete’s safety and health must be the most important factor. Only a licensed medical professional can make the determination as to whether an athlete has suffered a concussion. When in doubt, sit them out!

Under Ohio law, referees have as much responsibility to recognize the signs and symptoms of a possible concussion, as do coaches. If there is ever a disagreement between a coach and referee as to whether an athlete should be removed due to concussion symptoms, the referee’s decision has priority and the player should always be removed from play as a precaution.

After being removed from play/practice due to concussion signs, symptoms, or behaviors, a player is only allowed to return to practice, games, or participate in any way after the player has been assessed and cleared for return by a physician or by any other licensed heath care provider authorized by the youth sports organization. Written permission of clearance is required.

Referees and coaches are not allowed to let a player participate in future practices, games, or any soccer activities until AYSO has received written clearance of return to play from a physician or other licensed heath care provider. The AYSO Safety Director will notify you when this written permission has been received and a player is allowed to resume participation.

If a child is removed from play due to concussion signs, symptoms, or behaviors, a physician or health care provider who is licensed by the State of Ohio must evaluate them. Twinsburg AYSO will only accept written permission of clearance to return to play from a doctor or health care provider who currently holds a valid medical license with the State of Ohio. There are no exceptions to this rule.

What to do if a player has received a bump, blow or jolt to the head or body and she/he exhibits concussion symptoms:

If the player is exhibiting any of the concussion danger signs, the coach should call 911 immediately so the player can be transported to a hospital. An assistant coach should find the player’s parents/guardians and let them know the player needs immediate medical attention.

CONCUSSION DANGER SIGNS

In rare cases, a dangerous blood clot may form on the brain in a person with a concussion and crowd the brain against the skull. An athlete should receive immediate medical attention if after a bump, blow or jolt to the head or body s/he exhibits any of the following danger signs:

• One pupil larger than the other

• Is drowsy or cannot be awakened

• A headache that not only does not diminish, but gets worse

• Weakness, numbness, or decreased coordination

• Repeated vomiting or nausea

• Slurred speech

• Convulsions or seizures

• Cannot recognize people or places

• Becomes increasingly confused, restless, or agitated

• Has unusual behavior

• Loses consciousness (even a brief loss of consciousness should be taken seriously)

If the player exhibits one or more concussion symptoms after they have experienced a collision or fall that could have caused a concussion, remove the player from the game. Referees should inform both coaches of this decision. If there is disagreement, the referee’s decision has priority. The player’s coach should continue to watch them for any signs of concussion until the game is over.

SIGNS AND SYMPTOMS OF CONCUSSION

Signs and symptoms of concussion can show up right after the injury or may not appear or be noticed until days or weeks after the injury. If an athlete reports one or more symptoms of concussion listed below after a bump, blow, or jolt to the head or body, she or he should be kept out of play the day of the injury and until a health care professional, experienced in evaluating for concussion, says she or he is symptom-free and it’s OK to return to play.

SIGNS OBSERVED BY COACHING STAFF*

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 briefly)
Shows mood, behavior, or personality changes
Can’t recall events prior to hit or fall
Can’t recall events after hit or fall

SYMPTOMS REPORTED BY ATHLETES*

Headache or "pressure” in head
Nausea or vomiting
Balance problems or dizziness
Double or blurry vision
Sensitivity to light
Sensitivity to noise
Feeling sluggish, hazy, foggy, or groggy
Concentration or memory problems
Confusion
Just not "feeling right” or "feeling down”

The coach should talk with the player’s parents/guardian immediately after the game or practice and let them know what occurred. They will be referred to the CDC site for concussion symptoms to watch for over the next few days.

Contact the Twinsburg AYSO Safety Director as soon as possible. The current Twinsburg AYSO Safety Director is Patty Mold and she can be reached at 330-487-1063 or [email protected]. The league needs to know any time there is a removal from play due to a possible concussion. All registered AYSO players have Soccer Accident Insurance (SAI) that may assist with medical costs.

You may be asked to help complete the AYSO Incident Report Form with details and information about the incident.

In order for this player to return to soccer activities, the parent/guardian and their health care provider must complete the AYSO Participation Release Form and return it to the Twinsburg AYSO Safety Director. DO NOT ALLOW THE ATHLETE TO RETURN TO ANY SOCCER ACTIVITIES UNTIL THE AYSO SAFETY DIRECTOR NOTIFIES YOU.

We take every athlete’s safety very seriously. Concussions can be difficult to diagnose and can only be properly evaluated by a medical professional. We can all help athletes stay active and healthy by knowing the facts about concussion and when it is safe for athletes to return to play.

For more information:
Ohio Department of Health - Concussion in Youth Sports: Ohio's Return-to-Play Law
Ohio’s Return to Play Law: What Coaches and Referees Need to Know - Youth Sports
FrequentlyAsked Questions