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Pre-season concussion testing in high school students with academic difficulties or attention deficit hyperactivity disorder
  1. Mark Herceg1,2,
  2. Magdalena Wojtowicz3,4,5,
  3. Grant Iverson4,5,6
  1. 1Department of Neuropsychology, Burke Rehabilitation Hospital, White Plains, NY
  2. 2Department of Epidemiology & Community Health, New York Medical College, NY
  3. 3Clinical and Research Fellow, Dept. of Psychiatry and Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA
  4. 4Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston, MA
  5. 5MassGeneral Hospital for Children Sport Concussion Program, Boston, MA
  6. 6Neuropsychology Outcome Assessment Laboratory Dept. of Psychiatry and Physical Medicine and Rehabilitation, Harvard Medical School

Abstract

Objective Learning disabilities and/or ADHD are considered to be important risk factors or modifiers for concussion assessment and management. The purpose of this study was to examine cognition and symptom reporting in high school students with academic difficulties or ADHD and compare to those without at baseline.

Design Retrospective analysis of three measures routinely given as part of a high school yearly concussion baseline protocol.

Setting The library of a high school in Westchester County, NY.

Participants A sample of 143 high school students who participate in collision/contact sports [Age M (SD)=15.4 (1.2); Boys=78, 54.5%] completed baseline testing.

Main results Non-parametric tests were used because of violations of normality. High school students with academic difficulties or ADHD (n=21) were compared to controls (n=122) on King- Devick, SAC, ImPACT Cognitive Composite scores, and Total Symptom ratings. Students with LD or ADHD performed significantly more poorly on King-Devick (p=0.003; d=0.79), Visual Motor Speed Composite of ImPACT (p=0.007; d=0.79), and reported more symptoms at baseline on the Post-Concussion Scale (p=0.005; d=0.59). No significant differences found between groups on SAC (p=0.11; d=0.36) or ImPACT Verbal Memory (p=0.54; d=0.16), Visual Memory (p=0.20; d=0.26), or Reaction Time (p=0.14; d=0.55) Composites.

Conclusions To our knowledge this is the first study to examine performance on three different baseline measures. High school students with academic difficulties or ADHD performed more poorly on King-Devick, the Visual Motor Speed Composite of ImPACT, and reported more symptoms at baseline. Findings suggest these students need to be monitored for specific post injury changes.

This study was approved by the Committee for Human Rights Research, Burke Rehabilitation Hospital, White Plains, NY, USA. Protocol # BRC-455.

Competing interests None.

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