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Concussion Bill of Rights #5: Neuropsychological Testing For Contact and Collision Sports

Important in concussion evaluation and return to play decision

The current international consensus of experts (Zurich consensus statement)1, views neuropsychological (NP) testing as an "important component"  in determining when it is safe for an athlete to return to play after a concussion, and recommends formal baseline NP screening of athletes in all organized sports in which there is a high risk of concussion (e.g. football, hockey, lacrosse, soccer, basketball), regardless of the age or level of performance.

I therefore believe that parents should have the right to expect, if their child is playing contact or collision sports, that he or she undergo pre-season baseline and post-injury neuropsychological testing.

While baseline pre-injury and post-concussion testing is now ubiquitous at the professional and collegiate level and is becoming more common at the high school level as well (up to 42 percent in high schools with an athletic trainer, according to one recent study), the cost of either conventional pen-and-paper or computerized testing, and the fact that most states require advance training and licensing to purchase and use them, have thus far restricted how widely testing has been implemented at the youth level and in rural areas where access to neuropsychologists for consultation is limited.

Ways need to be found to fund such testing programs and to facilitate Web-based testing on a wide scale, especially for high risk sports such as football, hockey, soccer, basketball and lacrosse, regardless of the age or level, as the Zurich consensus statement strongly recommends.

1. Consensus Statement on Concussion in Sport: the 3rd International Conference on Concussion in Sport held in Zurich, November 2008.  Br. J. Sports Med. 20090: 43:i76-i84.

Revised and updated November 4, 2011