Sports Concussion Baseline Testing
Many current counts of concussion injury among children are based solely on emergency department visits or on organized high school and college athletics data, which means that youth concussions are being vastly undercounted. Much higher numbers of children may go to their primary care physician following a head injury, particularly for injuries fall on the mild end of the TBI continuum, rather than an emergency room. Still others may not seek any medical care at all.
Within days or weeks after sustaining a TBI, even a mild TBI, many young people present with a range of symptoms referred to as post-concussion syndrome. These symptoms might include headaches, dizziness, vertigo, memory problems, and difficulty concentrating, sleep problems, restlessness, irritability, apathy, depression, and anxiety. They may also have problems with executive functions such as planning, organization, and problem solving making it difficult to reintegrate in the same types of activities they were accustom to prior to their injury. The greatest recovery of function occurs within the first six months with much more gradual improvements after that point.
The aim of neuropsychological testing following a TBI is not so much for the purpose of making a diagnosis, but rather for identifying areas of strength and weakness and establishing a post-injury baseline against which one can measure improvements in functioning. What is often missing however is a measure of the young person’s preinjury baseline to compare with their post injury functioning. Given the rise in sports related head injuries amongst young people, baseline testing is considered “best practice” and may prove helpful should they experience a TBI.
Baseline testing is used to assess a young athlete’s neurocognitive functioning (e.g. memory and learning, attention, executive functioning, information processing speed, emotional and behavioral regulation, etc.). Results of baseline testing can then be used in comparison to similar measures administered after a concussion. Comparing baseline testing with measures administered following a head injury may assist healthcare professional in identifying the impact of a TBI and in planning returns to school and the field of competition. Baseline testing is completed prior to the start of the season and includes computer and/or paper pencil neuropsychological tests as well as a review of the athletes’ developmental and health history including history of prior concussions (e.g. nature of injury, post-concussion symptoms, length of recovery) and any existing psychological disorders (e.g. anxiety, mood disorder, learning disability, ADHD).