After son's tragedy, South Florida mother strives to reduce football concussions in youths

Saturday, August 04, 2012
by Hal Habib

Diana Brett was making a drive no mother should have to make.

Having learned that her 16-year-old son Daniel committed suicide, Brett climbed into her car to drive from Davie to the Palm Beach Gardens Police Department, which was handling the case. The officer who met her said she was in shock. She knew she was. Even so, she was thinking clearly enough to know the steps she wanted followed.

Daniel Brett was a football player. He had suffered multiple concussions and terrible headaches that confounded doctors for 1� years. Finally, while visiting a relative in Palm Beach County slightly more than a year ago, he drank beer, found the relative's gun and shot himself in the head.

The blast ended Daniel's life but began two quests for Diana.

First, she wanted answers, which is why she informed Gardens police she wanted her son's brain preserved to determine whether he had suffered from the disease that has claimed so many football players in recent years.

Second, she vowed to do all she could to prevent others from suffering the same pain.

"Nobody should go through this," she said.

For those dedicated to protecting football players from traumatic brain injuries, success often comes in small and medium doses. A significant step was achieved July 26 when the Cleveland Clinic agreed to underwrite a pilot program in which all Palm Beach County football players in public high schools will undergo baseline testing before the season. Because players can begin practice Monday, testing is under way.

The test, marketed as Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), is a 20-minute, computerized assessment often administered by trainers. Because everyone's cognitive skills are different, ImPACT gives doctors a "before" snapshot of an athlete's ability so that after an injury, the test can be retaken for a true measure of recovery. Because concussions take a cumulative toll on the brain, successive trauma can be exceptionally dangerous, doctors agree.

Palm Beach's pilot program moves the county a step closer to keeping pace with Miami-Dade, which has been using baseline testing for two years, and Broward, which began mandatory testing this year.

But more steps remain. Pop Warner football has begun sharply limiting the amount of contact players can endure in practice, and the NFL allows only 14 fully padded practices during the 17-week regular season. Yet similar safeguards do not exist on the high school level.

Strange as it may seem, a linebacker at Jupiter High, a guard at Boca Raton High or a running back at Dwyer can -- at least theoretically -- be subjected to more contact per week in practice than Miami Dolphins linebacker Karlos Dansby or tackle Jake Long.

That's not to say coaches at those or any other local schools are exposing players to unnecessary risks, but rather to point out that Florida high school teams are limited to 18 weekly hours of practice, workouts and game time during the regular season -- but nowhere in those bylaws are there restrictions on how much contact can occur within those 18 hours. The NFL has said it hopes the governing bodies of youth and high school football follow its lead.

"There absolutely should be limits to exposure to full contact in high school football," said Chris Nowinski, co-founder of the Boston-based Sports Legacy Institute, which is at the forefront of research on traumatic brain injuries in athletes.

"Limiting hours should be addressed immediately," added Nowinski, a former Harvard football player whose professional wrestling career was cut short because of concussions. "There is no way a 14-year-old playing football for fun should receive more blows to the head than a Miami Dolphin with informed consent playing for money."

Barring an act of Congress, such limitations won't occur on a national level. The National Federation of State High School Associations dictates playing rules but allows each state to regulate practices.

"I would be surprised if we didn't take a look at it," said Corey Sobers, spokesman for the Florida High School Athletic Association. "I think we've done a pretty good job of educating our coaches on this. The majority of them I don't believe would be trying to kill the kids with constant contact, especially if they want them to perform almost weekly for, if you're going deep in the playoffs, you're talking about 14 or 15 games. Is it something that needs to be addressed? Yeah."

Once the FHSAA takes up the matter, Sobers added, it wouldn't take long for restrictions to take effect. This year's safety rules, which require parents, coaches and athletes to educate themselves and sign consent forms, were discussed and implemented within a couple of months, Sobers said.

"The rules generally are made for the extreme coaches," Sobers said. "The majority of the coaches I don't think would abuse the situation, but there always seems to be a few."

Purdue University released a two-year study in February in which impact sensors were embedded in helmets of an Indiana high school team. It found that players received 200 to nearly 1,900 hits to the head per season, the most extreme of which carried more than 10 times the force a pilot feels while performing a roll in an F-16 fighter. And contrary to popular belief, researchers suggested that concussions are likely caused by repeated blows rather than a single jolt. Such evidence is why the Sports Legacy Institute and other advocates say a "hit count" is necessary to protect young, developing brains that are more susceptible to injury than those of adults.

Still, this culture change can be met with resistance. In Maryland, Thomas Hearn, father of an injured son, presented his school board with 12 pages of testimony while advocating contact limits. When Ned Sparks, the state's executive director of athletics, implied players already have limited contact, making restrictions a virtual nonissue, school board member Kate Walsh said, "So then why would we have a problem imposing that (regulation)?" The board formed a task force.

"That's got to be dictated by the board," said Vinny Scavo, director of athletic trainers at the University of Miami, who spent 17 years as a trainer in Miami-Dade County schools. "You have a high school pitcher who you put a pitch count on, right?"

Simple logistics afford some self-policing limitations. Since most teams play on Friday nights, many coaches opt for little if any contact on Thursdays and Saturdays, for example. Teams don't practice on Sundays. That leaves Mondays through Wednesdays for most contact work.

"You can't have too much contact or you'll lose a lot of people," Seminole Ridge coach Matt Dickmann said. If limits are put in writing, he wondered, "Who's going to follow the rules and who's not going to follow the rules? I mean, you basically are policing yourself and the people that have integrity will do what they're supposed to do and follow the rules. There's a lot of people that don't follow rules."

Benjamin coach Ron Ream said safety concerns prompted him to reduce contact about five years ago. With his players wearing full gear only on Tuesdays, he has seen a reduction in injuries, but he's cautious about NFL-style mandates.

"I think on the high school level, there's got to be a little more contact than the NFL," Ream said. "It's a reverse pyramid there because I think by the time they get to the NFL or major-college level, they should know how to hit, protect themselves. They should know how to use their shoulder pads, not their helmets, for initiating the blocking and tackling. But high school kids have got to be taught that."

The way to teach it, Ream said, has changed dramatically.

"We don't have any more 'bull in the ring,' " Ream said. "We don't have any more drills where there are 5- and 6-yard head starts to teach blocking and tackling. Now it's in closed quarters."

Baseline testing is gaining momentum as districts find creative ways to cover the cost. Damian Huttenhoff, who directs athletics for Broward schools, said grants from the University of Pittsburgh and Dick's Sporting Goods, in conjunction with Nova Southeastern researchers, cover the $60,000 tab (at about $10 per test). Miami-Dade's program is paid for through the fundraising campaign of David Goldstein, a senior at Miami-Ransom Everglades who suffered concussions while playing soccer. The program is run at the Miami Project to Cure Paralysis' KiDZ Neuroscience Center.

Goldstein and Diana Brett successfully pushed for Florida Senate Bill 256, which requires education of athletes, coaches and parents and a physician's approval before athletes can return to activity following a head injury.

Yetta Greene, instructional specialist for athletics in Palm Beach County, hopes to also conduct baseline testing on soccer and lacrosse players this school year before eventually expanding the program to cover all public school athletes.

It's difficult to pinpoint what could have prevented the Daniel Brett tragedy. He began playing youth football at age 11 and suffered up to 14 concussions, doctors said amid 19 months of tests. It wasn't until his mother took him to see UM doctors, including Gillian Hotz, director of the school's concussion program, that the extent of the damage was fully diagnosed. That was in March 2011. It was too late. Two months later, tragedy struck.

By then, Diana Brett had been in touch with the Sports Legacy Institute for treatment advice. Upon Daniel's death, she wanted SLI to determine whether he was the youngest person to contract chronic traumatic encephalopathy (CTE), the disease found in the brains of numerous NFL players who committed suicide, including Pahokee's Andre Waters. A study is under way to determine whether it also was a factor in Junior Seau's suicide.

Because Daniel shot himself in the head, researchers concluded there wasn't enough tissue to determine whether CTE was present. They did discover "abnormalities," his mother said.

She launched an annual 5K race, Daniel's Dash, that this year raised more than $10,000 for a foundation in Daniel's name dedicated to athletic safety.

"Why is a 16-year-old being studied next to these pro players for a possible same disease, which is a disease like dementia of an 80-year-old?" she said. "Those two things shouldn't correlate, shouldn't even be mentioned in the same sentence. But it's a fact. And that is a very loud fact right there, maybe to get people's attention."

Daniel Brett's sister, Marissa (left), and mother, Diana, hold a photo of the Broward County football player, who suffered concussions and severe headaches. He was 16 when he committed suicide while visiting a relative in Palm Beach County in 2011. (Photo by Robert Duyos/Sun Sentinel)