Colorado's multi-disciplinary concussion management (video)
- Created on Monday, 02 January 2012 14:43
- Last Updated on 17.05.2012
- Published Date

Centennial, Colo. -- Dr. Karen McAvoy was Cherry Creek School District's staff psychologist when freshman football player Jake Snakenberg died from second-impact syndrome in 2004. Out of that tragedy was born Colorado's concussion law, which became effective January 1, 2012 and a concussion management program known as REAP. Developed by Dr. McAvoy, REAP is a community-based concussion management program for families, schools, and medical professionals.
Dr. McAvoy describes REAP:
REDUCE – First and foremost, a concussed athlete must REDUCE physical demands (to prevent further injury). Equally important, the athlete must also REDUCE mental demands. See the REDUCE page in the REAP Manual for the story of “Jake Snakenberg”, a young athlete who died of second impact syndrome at the high school where REAP was developed. He was the inspiration for REAP as well as the Colorado Concussion Bill, appropriately named the “Jake Snakenberg Youth Concussion Act”.
EDUCATE – Since the symptoms “tell the story ”, members on all of the 4 teams must understand the significance of the symptoms and should watch, rate and track symptoms regularly (see the Symptom Checklist in the REAP Appendix).
ACCOMMODATE – The young athlete is a student first and an athlete second, therefore, all teachers must know how to “dial down” the academic demands for the student during the recovery. The ACCOMMODATE page in the REAP Manual helps teachers understand how to reduce academic demands.
PACE – Finally, when the multi-disciplinary team members decide that the athlete is asymptomatic and is functioning back to his/herself at school and home (and with neurocognitive testing, if available), they can coordinate their input with the Medical Team. Per legislation, the health care professional (ie. the Medical Team) gets to decide when to start the athlete back through the graduated Return-to-Play steps (see PACE in the REAP Manual for the Zurich Guidelines), however, with the REAP protocol, this pivotal decision now gets to be based upon multiple sources of data from multiple perspectives (stakeholders).
REAP feels strongly that the more “eyes” on the concussion, the better chance for a safer recovery.
REAP – Reduce/Educate/Accommodate/Pace is a concussion management protocol written for a Colorado school district to fill in the gap between REMOVAL-from-play and RETURN-to-play. REAP is based upon the premise that good concussion management requires a Multi-Disciplinary Team. It outlines the responsibilities of 4 teams:
• Family Team -- typically the parent or guardian, the athlete
• School Team – Physical (typically the school nurse, the athletic trainer, the PE teacher, the coach)
• School Team – Academic (typically the school counselor, psychologist, teachers, administrator)
• Medical Team – (typically the Primary Care Provider, the Sports Medicine Doctor/Clinic)
Karen McAvoy, PsyD is the author of REAP. She has 20+ years experience in the field of brain injury, working in a school district and is now the Director of the Center for Concussion, a program of Rocky Mountain Hospital for Children. REAP is a community-based program that can be replicated and implemented in any community, in any school district around the country. Contact Dr. McAvoy for details.
Karen McAvoy, Psy.D.
Director, Center for Concussion, a program of Rocky Mountain Hospital for Children
14000 E. Arapahoe Road, Suite #300
Centennial, CO. 80112
Phone: 720-979-0840
Questions/comments? Contact Jean Rickerson at This email address is being protected from spambots. You need JavaScript enabled to view it.
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Concussions Occur...
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REMOVE athlete from play
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REST no sports, no texting/TV
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Source: Children's Hospital Boston, Sports Concussion Clinic




















