Subcommittee on Sports-Related Concussions in Canada Committee on Jan. 30th, 2019

[Peter Niedre]

I'm not aware of the data that really links those two.

Again, as Paul said, we're struggling with just keeping data from sports on the actual incidence of concussion. As Paul said, we do need a database around who are suffering from that, because when we think about all these interventions, we need to see how concussions are impacting mental health.

From a mental health perspective, I can't speak to that. Anecdotally, I've heard stories. The thing about mental health as well, as we're all aware, is that we are encouraging athletes, anybody, to speak more about it. The reality is that there are some who don't. There are some who might not even come forth as wanting to do that. That's an issue we face, too, as part of this. When we're trying to do something that's evidence-based, we're sometimes very limited to those things.

[Alexander Nuttall]

Thank you.

[The Chair]

We will now be moving over to the Liberals. This will be the last member and questioner for this round. It's Mr. Darren Fisher.

[Darren Fisher, Dartmouth—Cole Harbour, Lib.]

Thank you very much.

Thanks, gentlemen, very much for this.

This is going to seem as though I'm all over the place.

First of all, is Rugby Canada under the Coaching Association of Canada? Is it one of your 66?

[Peter Niedre]

Yes, we're partners with Rugby Canada. That's correct.

[Darren Fisher]

You talked about training. I'm really interested, Peter, in retraining. I'll use hockey as an example, because that's the area I know the best.

My son had a coach when he was five years old who is still coaching. Would I be right in assuming that there are regular retraining sessions? What we know about concussions now—and a lot of this falls on the coach—is so much greater than what we knew 12 years ago, when my son started playing hockey.

How much retraining is there? Is it yearly? Does it even occur? Can you speak for Hockey Canada as to whether there's constant retraining?

[Peter Niedre]

What we have as a policy in the national coaching certification program is what is called the maintenance of certification policy. It means that coaches who are certified in the NCCP must maintain their certification on a five-year cycle. Every five years they must renew it through professional development. We have a points system. They take various professional development opportunities to accumulate the points and maintain their certification.

[Darren Fisher]

They get the opportunity to do that. Are they held to a standard whereby they must do it to continue coaching?

[Peter Niedre]

If a coach does not maintain that certification, basically their status becomes certified not renewed. However, it's up to the sports to look at how they implement that not renewed status.

Hockey is working on how this works with respect to being on the bench, and sports are working through what this certified status and certified not renewed status mean, which means that through their legislation concerning what the rules are from the code of safety perspective on the bench they make sure their coaches are maintaining their certification. We notify the coaches well in advance that this is happening.

[Darren Fisher]

Paul, in your former role you were manager of national coach development. When you're developing a coach, what part of your process of developing a coach for, let's say, youth rugby is focused on concussion?

Both of you have talked, and many people have talked, about identifying concussion. We hear a little bit less about prevention. Maybe you can touch on what your role was before you were interim director and how you would approach it from a concussion point of view.

[Paul Hunter]

We decided to make our online training annual, for the reason that we would never go 12 months without any new information being introduced to a coach, whether it be a change of the law of the game or anything from the medical side.

The two pieces we have in our training annually online comprise the rugby ready, how you coach the five areas of contact in rugby. We have a law variation coming in. That means everyone will not go more than 12 months without this new cycle of the new laws coming in.

The concussion management training is separate. It does not involve the technical and tactical aspects of the sport. It is signs and symptoms identification and management. For example, one of the changes we have there involves some research we have that are warm-ups that can equate to a reduction in concussion. This is going to be integrated into the prevention piece.

We have two pieces of online training that will be done annually. We've mandated it for all coaches and players. Our jurisdiction is over the club environment; however, many school boards will adopt Rugby Canada's policy, so many of the school boards are doing it. We, however, mandate that all club coaches and referees must do this every 12 months.

Technical and tactical training is online, as is detection. The prevention piece is supporting the coach on how to technically coach the five areas within our game, and then the concussion management for the general public is on how to identify and detect and manage the signs and symptoms of concussion.

[Darren Fisher]

Zero tolerance?

[Paul Hunter]

Yes.

[Darren Fisher]

Do you find that zero tolerance has an effect on changing behaviour? We've seen it in hockey. Someone could be suspended for five games, then come back the next game and be suspended again for doing the exact same behaviour. We've been told by people in one of the rooms we've met in during this study—and we've heard it from mothers and fathers and young athletes—that the penalties do not change behaviour.

Does zero tolerance in rugby change behaviour?

[Paul Hunter]

Yes. I don't think there's any single, explicit answer that will reduce and eliminate.... I think there are multiple pieces. I think zero tolerance plays a deterrent part, especially around deliberate contact to the head; around accidental contact, maybe per coaching, per understanding from the player. But yes, I do believe that you will see a reduction in the hate in which you go into a contact. That's an education piece.

We asked before about how we change a culture. It's going to take time to change a culture. We're not going to see an immediate change. I would say role models play a key part: what our international athletes, what our professional athletes do. If we see on TV something that is a zero tolerance then that's going to filter down to our young kids. So, yes, I do believe that a zero tolerance approach to contact to the head does reduce concussion-related injuries.

[The Chair]

Thank you, Mr. Hunter.

[Paul Hunter]

I think Hockey Canada has done some fantastic research there.

[The Chair]

We'd like to thank Rugby Canada, Mr. Paul Hunter, and the Coaching Association of Canada, Mr. Peter Niedre. It sounds like you work well in tandem, and everybody is looking for the best approach to this and how we can find some solutions to some difficult questions.

Thank you so much, and to the members for their questions.

[Peter Niedre]

Thank you, gentlemen.

[Paul Hunter]

Thank you.

[The Chair]

We're going to transition now into our second round with our next witnesses.

[The Chair]

We're going to commence again. It's great. We've just heard from our first witnesses. Now we have our second round.

From the Children's Hospital of Eastern Ontario, we have Dr. Roger Zemek, Director of Clinical Research. From Parachute Canada, we have Pamela Fuselli, Vice-President of Knowledge Transfer and Stakeholder Relations.

What was great, I'd say to the members, is that both of these witnesses listened to our first witnesses. There may be some information they may be able to impart to us from the questions they heard.

We are going to commence with the Liberals again in this first round. That will be Mr. Darren Fisher—

[Mona Fortier]

They present first.

[The Chair]

Oh yes, that's right. I did that again. Okay, I somehow want to jump right into the questions.

[Darren Fisher]

I don't want to go first.