Every state has laws governing concussion in school sports. Those laws depend on a suspected injury being recognized and reported, which is where the variation lives.
The protocol begins with an observation
Typical statutes require that an athlete suspected of a concussion be removed from play immediately and not return until cleared by an appropriate health care provider.
That structure is only as strong as the initial recognition. Nothing in the protocol activates unless a coach, official, trainer, teammate or the athlete herself flags a possible injury.
Specific requirements, who may provide clearance and what training coaches receive vary by state and are amended over time, so the state association and the school's policy are the operative documents.
Recognition depends on who is watching
A certified athletic trainer on site changes recognition substantially, because assessment is that person's job rather than an interruption to coaching a game in progress.
Coverage is uneven across schools and across teams within a school, and it tends to follow the same order that governs officials, facilities and transportation.
Where no trainer is present, recognition falls to adults with a competing incentive, which is a structural problem rather than a comment on any individual coach.
Athletes weigh the consequences of reporting
Reporting means removal from the game, a clearance process and a period out of play, potentially including a role on the team when she returns.
Athletes on the margin of a roster or in a recruiting year have the most to lose from time out and are therefore least likely to volunteer a symptom.
Programs where a reported symptom is met with routine handling rather than visible frustration report differently, which is the part of the culture a coach actually controls.
Symptoms are not only immediate
Some symptoms appear or worsen over the following hours and days, which means an athlete who seemed fine at the end of a game can still need evaluation.
Headache, confusion, sensitivity to light or noise, sleep disruption and difficulty concentrating are commonly described, and any suspected head injury needs assessment by a qualified clinician rather than judgment at home.
The academic side is part of recovery
Recovery affects concentration and screen tolerance, so a return-to-learn plan with teachers matters alongside return to play, and many state policies address both.
Families who ask early about academic accommodations avoid a second problem, since a student recovering physically can still fall behind in a way that takes a semester to repair.