Baseline pre-injury and post-injury neuropsychological testing is now commonplace at the professional and collegiate level, and has become more and more common at the high school level as well, with a recent study showing computerized neuropsychological testing being used to assess fully 41.2% of concussions at schools at least one athletic trainer on staff in the 2009-2010 year,2 an increased of 15.5% from the 25.7% of concussions in which such testing was used in assessing concussions during the 2008-2009 school year.3
Pen-and-paper tests
Standard pencil and paper neuropsychological tests (see box) have proven useful for identifying cognitive deficits resulting from concussions, and have been available to sports medicine clinicians for several years. These tests are designed to assess various domains of cognitive functioning such as short-term memory, working memory, attention, concentration, visual spatial capacity, information processing speed, and reaction time. The tests assist clinicians in quantifying the severity of the injury and eliminating some of the guesswork. The key to a successful testing program is having results from pre-season baseline testing for comparison to post-injury results.
| Common Neuropsychological Tests Used in Sport Concussion Assessment4 | |
| Neuropsychological Test | Cognitive Domain |
| Controlled Oral Word Association | Verbal Fluency |
| Hopkins Verbal Learning Test | Verbal learning, immediate and delayed memory |
| Trail Making: Parts A and B | Visual scanning, attention, information processing speed, psychomotor speed |
| Wechsler Letter Number Sequencing Test | Verbal working memory |
| Wechsler Digit Span: Digits Forward and Digits Backward | Attention, concentration |
| Symbol Digit Modalities Test | Psychomotor speed, attention, concentration |
| Paced Auditory Serial Addition Test | Attention, concentration |
| Stroop Color Word Test | Attention, information processing speed |
Because most states require advance training and licensing to purchase and use NP tests, and they are copyright protected, the National Athletic Training Association's 2004 Position Statement4 recommends that a licensed psychologist, preferably board-certified in clinical neuropsychology or with clinical experience in evaluating sport-related concussions, oversee and supervise the testing. The Zurich consensus statement echoes that position ("Neuropsychologists are in the best position to interpret NP tests by virtue of their background and training.").
This is helpful article for
This is helpful article for not only mums and dads, but as a tool to demonstrate to their often heady children demanding to return to sport after illness.
Schools should encourage
Perhaps schools should encourage student athletes involved in contact sports to participate in this medical test after every competition to assess their head injuries if any.