A team approach to concussion management in youth and high school sports, which includes a sports physician, neuropsychologist and athletic trainer, is optimal, especially given the vulnerability of youth to traumatic brain injury.
Ideally, the care of youth athletes who sustain concussions should be overseen by:
Although this may be the optimal team, in reality many schools or athletic programs do not have such healthcare professionals available to them.
But just because there may not be enough of all of these trained healthcare professionals to go around does not mean we shouldn't strive for optimal care.
So where do we go from here?
One possible solution to the shortage of neuropsychologists (and the expense that hiring them would entail) would be to include school psychologists already on staff in school districts, and who already have some training in brain disorders and neurocognitive testing, as part of a school's concussion care team. Such psychologists could be particularly instrumental in transitioning the concussed youth back to school with appropriate academic accommodations [1] and a 504 or Individual Education Plan as needed.7
We have an obligation to care for the brains of our youth athletes and to make sports safe and fun. To that end, U.S. Representative Bill Pascrell Jr. and U.S. Senator Robert Menendez, co-sponsors of the ConTACT bill, officially announced on September 27, 2011 that the Centers for Disease Control and Prevention (CDC) will be convening a panel of experts to develop national guidelines for the management of sports concussion in youth.
1. Moser RS, Iverson G, Echemendia R, Lovell M, Schatz P, Webbe F, Ruff R, Barth J., et al. NAN Position Paper: Neuropsychological evaluation in the diagnosis and management of sports-related concussion. Arch. Clin Neuropsychology 2007; 22:909-916.
2. Barth, JT. Athletic Laboratory (1998). Recovery, 9(3), 301-331.
3. Meehan WP, d'Hemecourt P, Collins C, Comstock RD, Assessment and Management of Sport-Related Concussions in United States High Schools. Am. J. Sports Med.2011;20(10)(published online on October 3, 2011 ahead of print) as dol:10.1177/0363546511423503 (accessed October 3, 2011).
4. Waxenberg R, Satloff E. Athletic trainers fill a necessary niche in secondary schools. National Athletic Trainers' Association: 2009. Available at: http://www.nata.org/NR031209 [9].
5. Moser RS, Schatz P, Neidzwski K, Ott SD. Does Group vs. Individual Administration Affect Baseline Neurocognitive Test Performance? Am. J. Sports Med. 2011; DOI: 10.1177/0363546511417114.
6. Schatz P, Moser RS, Solomon GS, Ott SD, Karpf R. Incidence of invalid computerized baseline neurocognitive test results in high school and college students. J. Ath. Tr. (in press)
7. Moser, RS. The growing public health concern of sports concussion: The new psychology practice frontier. Professional Psychology: Research and Practice. 2007;38(6), 699-704.
Posted October 12, 2011; updated December 28, 2011
Links:
[1] https://momsteam.com/node/3549
[2] https://momsteam.com/node/128
[3] https://momsteam.com/node/221
[4] https://momsteam.com/node/149
[5] https://momsteam.com/node/3935
[6] https://momsteam.com/node/3015
[7] https://momsteam.com/node/3385
[8] https://momsteam.com/node/3471
[9] http://www.nata.org/NR031209
[10] https://momsteam.com/health-safety/neuropsychologist-should-help-plan-academic-accommodations-after-concussion
[11] https://momsteam.com/health-safety/athletic-trainer-plays-key-role-in-concussion-recognition-evaluation-on-sports-sideline
[12] https://momsteam.com/health-safety/athletic-trainers-primary-care-doctors-treat-most-concussions-in-high-school-sports-study-finds
[13] https://momsteam.com/baseline/baseline-neuropsychological-tests-getting-valid-results-poses-challenge
[14] https://momsteam.com/scat2/baseline-scores-vary-by-youth-athletes-gender-concussion-history-says-study
[15] https://momsteam.com/impact/computerized-neuropsychological-testing-has-important-role-in-concussion-evaluation-return-play