Tyler Layer doesn’t remember the hit that took him out of football for good last August or the two weeks that followed.

The hit knocked him out for a minute or two and caused him to miss the season. When he suffered a second concussion after a fall at home this summer, his doctor made it official: No more football. The risk of further injury to his brain was too great.

Experts hope regulations put into place last year regarding concussions in high school athletes will prevent long-term damage in teens like Tyler. It’s too soon to tell, though, if the rules are having the desired effect, they say.

The Ohio High School Athletic Association, like its counterparts nationally, requires that athletes who show signs of a concussion — loss of consciousness, dizziness, confusion, headache and vomiting or nausea — be pulled out of a game. To return to play that day, they need to be cleared by a doctor, osteopath or licensed athletic trainer who certifies that they don’t have a concussion, said OHSAA spokesman Tim Stried.

“It makes coaches and officials keep an eye out for these types of injuries and make sure the kids get referred to medical professionals,” said athletic trainer Robin Lensch, who works for the Kettering Health Network. She works with athletes in the Kettering City Schools.

Athletes diagnosed with a concussion are required to rest and get medical clearance before they can return to practice and competition.

The time off gives athletes’ brains a chance to heal, said Dr. James Tytko, a sports medicine specialist with Kettering Health Network. It also reduces the risk for another immediate concussion. The biggest risk factor for subsequent concussions is that first concussion. Each shock to the brain makes it more vulnerable for long-lasting damage, he said.

Consequences of repeated concussions are in the spotlight now for both for athletes and soldiers. The National Football League is fighting off more than 100 lawsuits filed by former players who allege the league failed to inform them of the risks of repeated head injuries. Former NFL players have stepped forward in recent years, speaking of depression, memory loss and even dementia they believe were caused by repeated concussions and other head injuries during their years on the field.

Treating and preventing concussions in teens and younger athletes can help prevent issuesthat may not become apparent for decades, local experts say, and the attention surrounding the NFL and its former players is helping raise awareness.

“We used to just see children who played football coming in,” said Dr. Jay Gosalakkal, a pediatric neurologist at Children’s Medical Center of Dayton. “Now we’re seeing other sports as well, like basketball, and more soccer.”

It’s only been in recent years that doctors, coaches, athletic trainers and athletes and their parents have learned to connect the dots between concussion and later problems in school and life. The symptoms can be subtle — grades sliding, emotional outbursts, memory lapses and behavioral problems — and might be attributed to typical teenage behavior.

The new regulations are forcing coaches, athletes and parents to take concussions more seriously, Lensch said.

The regulations can’t prevent concussions, said Rick Meeks, football coach at Shawnee High School. “But for kids who get them, they can prevent that future damage,” he said. “It’s a little more time for us to make sure they’re really OK.”

But some coaches see the policy requiring medical clearance as unnecessary, though they still follow it.

“You show me something that says, ‘We’ve got to do this to keep our kids safe,’ and I’ll do it,” said Troy Everhart, football coach at Middletown.

But he worries that requiring every player who suffers what might or might not be a concussion to sit out until they get a medical clearance is costing some the chance for scholarships.

“He’s got to be seen by a doctor before he can play again. But some kids can’t be seen by a doctor immediately,” he said.

Everhart called the policy “a knee-jerk reaction” and pointed out that doctors found no evidence of brain trauma in Junior Seau, who committed suicide in May. Seau suffered several concussions while an NFL linebacker for the San Diego Chargers, Miami Dolphins and New England Patriots. He retired in 2010.

But Ray Easterling, a defensive back for the Atlanta Falcons in the 1970s, died in April of a self-inflicted gunshot wound. He was one of the first NFL players to sue the league. He had been diagnosed with dementia and, according to his widow, had suffered with depression and memory problems for years before his death. An autopsy found he had suffered chronic traumatic encephalopathy as a result of repeated brain injuries.

Other school sports officials say they’re in favor of any policy that reduces students’ risk for injury.

“Anything we can do for the safety of athletes in sports competitions, we need to do,” said Jim Smerz, athletic director at Beavercreek High School. The school contracts with Miami Valley Hospital for trainers and sports medicine specialists.

OHSAA requires coaches and officials to learn the signs of concussion, and Beavercreek, like most schools, meets with parents every year to educate them on the risks of concussions and the medical clearance policy.

OHSAA started collecting data last year for the first time on concussions sustained during competition for all of the sports it regulates. With only a year’s worth of data under its belt, it’s too soon to speculate how OHSAA might use the data, Stried said.

For boys, wrestling led the way, with 111 concussions reported, followed by football with 102. For girls, basketball had the highest number of concussions reported at 25. Soccer and softball tied for second place, with 13 each.

Tyler’s injury happened during a football practice last August.

“They went to block during a drill and he went facemask-to-facemask with the other player, who weighed about 80 pounds more, and he flew backwards and hit his head on the ground and was knocked unconscious,” said his father, Mike Layer.

After he needed therapy to regain his balance and concentration for school work. It was difficult for him to sit and read and then recall what he read. He also had problems sleeping.Only about 20 percent of the student athletes Lensch works with need extensive treatment after concussion. Most heal on their own within about a week, she said.

The Layers like OHSAA’s medical clearance policy. “I think it’s wonderful that nothing’s left up to the coach. It’s all up to the trainer or the doctor,” said Renae Layer, Tyler’s mother.

Dr. Sean Convery, medical director of sports medicine at Miami Valley Hospital in Dayton, estimates 30 to 40 percent of the student athletes he treats have suffered “a couple” concussions or more.

“It’s very rare that you see a kid who plays soccer or football get through high school who’s never had a concussion,” Convery said.

Kettering Health Network recently launched its Concussion and Brain Injury Center on the Southview Medical Center campus in Centerville. The center offers balance training and physical, occupational and speech therapy for brain injury patients from across the nation.

More and more teams around the U.S. are starting to use ImPACT testing, a brain injury measurement test for children and teens. The computerized test measures reaction time, memory and other mental functions, to document brain function before and after concussion. Athletes take a baseline test at the beginning of each year; if they suffer a concussion, they take a second test to assess the damage and gauge their recovery. Lensch used the test on Tyler, and with other athletes she’s trained.

ImPACT testing can show the damage done on athletes’ ability to remember and react to information. The results help medical professionals gauge the extent of the injury, Lensch said, but they also give athletes and their coaches and parents proof that something is actually wrong.

“The results really validate the injury for the kids,” she said.