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Introducing the Child Sport Concussion Assessment Tool 6 (Child SCAT6)
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  1. Gavin A Davis1,2,
  2. Ruben J Echemendia3,4,
  3. Osman Hassan Ahmed5,6,7,
  4. Vicki Anderson8,9,
  5. C Blauwet10,
  6. Benjamin L Brett11,
  7. Steven Broglio12,
  8. Jared M Bruce13,
  9. Joel S Burma14,
  10. Gerard A Gioia15,16,
  11. Christopher C Giza17,18,
  12. Kevin M Guskiewicz19,
  13. Kimberly G Harmon20,
  14. Stanley Herring21,
  15. Michael Makdissi22,23,
  16. Christina L Master24,25,
  17. Michael McCrea26,
  18. Tamara C Valovich McLeod27,
  19. William P Meehan, III28,29,
  20. Dhiren Naidu30,
  21. Jon Patricios31,
  22. Laura K Purcell32,
  23. Margot Putukian33,
  24. Kathryn J Schneider34,
  25. Samuel R Walton35,
  26. Keith Owen Yeates36,
  27. Roger Zemek37
  1. 1 Murdoch Children's Research Institute, Parkville, Victoria, Australia
  2. 2 Neurosurgery, Cabrini Health, Malvern, Victoria, Australia
  3. 3 Psychology, University of Missouri, Kansas City, Missouri, USA
  4. 4 Psychological and Neurobehavioral Associates, Inc, Kansas City, Missouri, USA
  5. 5 Physiotherapy Department, University Hospitals Dorset NHS Foundation Trust, Poole, UK
  6. 6 The FA Centre for Para Football Research, The Football Association, Burton-Upon-Trent, UK
  7. 7 School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
  8. 8 Psychology, University of Melbourne, Parkville, Victoria, Australia
  9. 9 Brain and Mind, Murdoch Children's Research Institute, Parkville, Victoria, Australia
  10. 10 Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
  11. 11 Neurosurgery/Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  12. 12 Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan, USA
  13. 13 Biomedical and Health Informatics, University of Missouri, Kansas City, Missouri, USA
  14. 14 Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
  15. 15 Children's National Health System, Washington, District of Columbia, USA
  16. 16 School of Medicine, George Washington University, Washington, DC, USA
  17. 17 Neurosurgery, UCLA Steve Tisch BrainSPORT Program, Los Angeles, California, USA
  18. 18 Pediatrics/Pediatric Neurology, Mattel Children's Hospital UCLA, Los Angeles, California, USA
  19. 19 Sports Medicine Research Laboratory, University of North Carolina, Chapel Hill, North Carolina, USA
  20. 20 Family Medicine, University of Washington, Seattle, Washington, USA
  21. 21 Departments of Rehabilitation Medicine, Orthopaedics and Sports Medicine and Neurological Surgery, University of Washington, Seattle, Washington, USA
  22. 22 Florey Institute of Neuroscience and Mental Health - Austin Campus, Heidelberg, Victoria, Australia
  23. 23 La Trobe Sport and Exercise Medicine Research Centre, Melbourne, Victoria, Australia
  24. 24 University of Pennsylvania, Philadelphia, Pennsylvania, USA
  25. 25 Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
  26. 26 Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  27. 27 Department of Athletic Training and School of Osteopathic Medicine, A.T. Still University, Mesa, Arizona, USA
  28. 28 Sports Medicine, Children's Hospital Boston, Boston, Massachusetts, USA
  29. 29 Emergency Medicine, Children's Hospital Boston, Boston, Massachusetts, USA
  30. 30 Medicine, University of Alberta, Edmonton, Alberta, Canada
  31. 31 Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa
  32. 32 McMaster University, Hamilton, Ontario, Canada
  33. 33 Major League Soccer, Princeton, New Jersey, USA
  34. 34 Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
  35. 35 Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
  36. 36 Psychology, University of Calgary, Calgary, Alberta, Canada
  37. 37 Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
  1. Correspondence to Professor Gavin A Davis, Neurosurgery, Cabrini Health, Malvern, VIC 3144, Australia; gavin.davis{at}me.com

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Background and rationale

The requirement for a child-specific tool that can be used by health care professionals (HCPs) in the management of sport-related concussion (SRC) was recognised by the Concussion in Sport Group (CISG) in 2012 with the introduction of the Child Sport Concussion Assessment Tool 3 (Child SCAT3) for use with children ages 5–12 years.1 This tool paralleled and complemented the SCAT3, which was developed for use in athletes, ages 13 years and over.1 The CISG revised the Child SCAT3 following the fifth International Consensus Conference on Concussion in Sport (Berlin 2016), with the release of the Child SCAT5.2 At that time, the version number (5) was chosen to align the version number with the consensus meeting number, and therefore, there is no Child SCAT4.

During 6th International Conference on Concussion in Sport held in Amsterdam in 2022, the CISG reviewed the evidence to implement improvements to the Child SCAT5 and develop the Child SCAT6.

Process for development

The 6th International Conference on Concussion in Sport followed a consensus development process, incorporating multiple systematic reviews, an open forum meeting with additional poster abstracts, and expert panel deliberations following the meeting.3 A systematic review of the acute detection of SRC was performed to evaluate the literature examining the identification and assessment of SRC in the acute phase of injury and provide recommendations for improving the SCAT and Child SCAT tools.4 The systematic review indicated that the SCAT tools were most appropriate for the acute assessment of concussion, up to 7 days post-injury, and optimally within 72 hours of injury. In the subacute period (beyond 72 hours), the new Sport Concussion Office Assessment Tool 6 (SCOAT6) and Child SCOAT6 tools should be used.5–7 Subsequent to the open meeting and expert panel consensus meeting, a subgroup of the Amsterdam panel met on a separate day dedicated to developing revised versions of the tools, including the Child SCAT6.

The systematic reviews, open conference and panel discussions addressed the required modifications for the SCAT6 and Child SCAT6. The panel deliberations resulted in a revised SCAT6,8 and incorporating these results, reached consensus on application of these modifications to the Child SCAT6. The first issue addressed was age appropriateness, and careful evaluation of the data determined that the Child SCAT6 was most appropriate for children ages 8–12 years, with limited evidence supporting its utility in children ages 5–7 years. It was further determined that use of the SCAT6 in adolescents (ages 13–18 years) would be appropriate. A separate tool, the Concussion Recognition Tool 6, has been developed for use by non-medically trained individuals for the identification and immediate management of suspected concussion.9

Content of the Child SCAT6

Modifications for the Child SCAT6

  • The Child SCAT6 is for use in children ages 8–12 years.

  • The Child SCAT6 is intended for use in the acute phase (72 hours) postinjury, but can be used up to 7 days postinjury.

  • Red Flags — added Glasgow Coma Score (GCS)<15 and visible deformity of the skull.

  • Preferred language added to demographics section.

  • ‘Office assessment’ removed.

  • Moved the Neurological Screen to the Immediate Assessment (including Observable Signs, GCS, Cervical Spine and Ocular/Motor Assessment), and added components to other sections.

    • Observable signs — added impact seizure, falling unprotected to the surface and high-risk mechanism of injury.

    • Cervical spine assessment — added tenderness to palpation.

    • Added coordination and oculomotor screen to follow cervical spine assessment.

    • Modified finger-to-nose to perform eyes open, then eyes closed.

  • Athlete background — modified terminology ‘diagnosis of psychiatric disorder’ to ‘psychological disorder’

  • Symptom evaluation—moved neck symptoms to the end of list to maintain original Health and Behaviour Inventory10 item order.

  • Moved total symptom scores to follow completion of athlete answers to worsening of symptoms and overall assessment

  • Immediate memory — removal of 5-word lists; instead recommend 10-word list for all children.

  • Days in reverse order — time to complete is recorded, and correct response accepted only if completed within 30 s.

  • Balance — Modified Balance Error Scoring System (mBESS) — all three stances (double leg, single leg, tandem stance) to be assessed; option to include assessment on foam surface; proceed to tandem gait/complex tandem gait and dual-task tandem gait if no significant difficulties with mBESS.

  • Tandem gait — child performs three timed trials, and fastest trial is recorded.

  • Addition of complex tandem gait — forward and backwards, each with eyes open and eyes closed.11

  • Dual-Task tandem gait — added as an optional task; assesses tandem gait while simultaneously performing a cognitive task (eg, count backwards by 3’s), and assess errors and time to completion.

  • Return-to-learn recommendations modified, consistent with the recommendations from the systematic review.12

  • Retur-to-sport recommendations modified, with inclusion of two stages of aerobic exercise, consistent with the findings of the systematic reviews on Rest and Exercise,13 Rehabilitation14 and Return to Sport.12

How to use the Child SCAT6

The Child SCAT6 provides the HCP with a tool to use in the acute period following SRC. The emphasis on the initial 72 hours postinjury provides clarity in the operational application of the Child SCAT6, with subacute assessment addressed with the Child SCOAT6.

A consistent finding from the systematic reviews and panel discussions during the Amsterdam meeting was the limited data available on SRC in children 5–7 years of age. Developmentally, these younger children are quite different from 8 to 12 years old children, and thus, the validated components of the Child SCAT6 were determined to be most appropriate for children ages 8–12 years. While the CISG did not develop a separate tool for children ages 5–7 years, we acknowledge that some HCPs experienced in the management of paediatric SRC may continue to use some elements of the Child SCAT6 in children aged 5–7 years, making modifications to the assessment as required; however, no validated or normative data are available to support use in this age group, and caution is required when used with younger children.

The Child SCAT6 is for use in all children ages 8–12 years; however, many components of the tool have not been validated in children with disabilities, or across diverse cultural and language groups. During the Amsterdam meeting, the requirements of the para athlete were emphasised, and the paucity of data on the paediatric para athlete suggests that significant work is required to develop age-appropriate tools for the para athlete in the school, community and elite settings.

The Child SCAT6 is available for free, unrestricted distribution for use in childhood SRC, provided that no modifications are made to the tool. The development of the tool is evidence informed, and we encourage its widespread distribution and use by HCPs worldwide.

Supplemental material

Ethics statements

Patient consent for publication

Acknowledgments

The authors gratefully acknowledge the work of the coauthors of the systematic review that served as a foundation for the SCAT6: Juan Carlos Arango-Lasprilla, Christopher M. Bailey, Neil Bhathela, Amanda M. Black, Nyaz Didehbani, James Kissick, Simon Kemp, Jamie Pardini, Zahra Premji and Danielle Salmon. We also want to recognise the assistance of librarians Alix Hayden and Heather Ganshorn, and Corson Johnson, Candice Goerger, Shauna Rutherford, Kenzie Vaandering, Stacy Sick, and Kirsten Holte for their help with various aspects of the systematic review.

References

Footnotes

  • Twitter @osmanhahmed, @VickiAn28323584, @BenjaminBrett1, @griz1, @DrKimHarmon, @drtinamaster, @TamaraCVMcLeod, @jonpatricios, @Kat_Schneider7, @SammoWalton

  • Contributors GAD served as the primary author and responsible for all aspects of the project, including initial preparation, coordination, review, editing and final preparation of the manuscript and Child SCAT6 tool. RJE served as the primary author of the systematic review and development of the SCAT6 manuscript and tool. All coauthors contributed to the development and critical review of the manuscript and Child SCAT6 tool, and approved the final version of the manuscript and tool.

  • Funding Education grant from the Concussion in Sport International Consensus Conference Organising Committee through Publi Creations for partial administrative and operational costs associated with the writing of the systematic reviews and tool design.

  • Competing interests GAD is a member of the Scientific Committee of the 6th International Conference on Concussion in Sport; an honorary member of the AFL Concussion Scientific Committee; Section Editor, Sport and Rehabilitation, NEUROSURGERY; and has attended meetings organised by sporting organisations including the NFL, NRL, IIHF, IOC and FIFA; however has not received any payment, research funding, or other monies from these groups other than for travel costs. RJE is a paid consultant for the NHL and cochair of the NHL/ NHLPA Concussion Subcommittee. He is also a paid consultant and chair of the Major League Soccer concussion committee and a consultant to the US Soccer Federation. He previously served as aneuropsychology consultant to Princeton University Athletic Medicine and Eye Guide. He iscurrently a co-PI for a grant funded by the NFL (NFL-Long) through Boston Children’s Hospital. He occasionally provides expert testimony in matters related to MTBI and sports concussion and occasionally receives honoraria and travel support/reimbursement for professional meetings. OHA is a Senior Physiotherapist at University Hospitals Dorset NHS Foundation Trust (England) and is Para Football Physiotherapy Lead/Para Football Classification Lead at the Football Association (England). He also works on a consultancy basis with the Football Association as the squad physiotherapist to the England Cerebral Palsy Football squad and teaches on the Football Association's Advanced Trauma and Medical Management in Football course on a consultancy basis. He has a Visiting Senior Lecturer position at the University of Portsmouth, England (unpaid). He sits on several disability sport committees including Para Football Foundation as Medical Unit Co-Lead (unpaid), the International Federation of Cerebral Palsy Football as Medical and Sports Science Director (unpaid), and the International Blind Sports Association as Medical Committee member (unpaid). He has Associate Editor position sat the British Journal of Sports Medicine (unpaid) and BMJ Open Sports & Exercise Medicine (unpaid). He is also an Institutional Ethics Committee external member for World Rugby (unpaid) and co-chair of the Concussion in Para Sport Group (unpaid). VA: Financial: Australian National Health and Medical Research Council and Medical Research Future fund: research grants. Royalties: Pearson Publishing (Test of Everyday Attention) Collaboration: Australian Football League (Partnership agreement to fund research – funds go to my institute) Boards: Editorship: Journal of Neuropsychology, Neuropsychology, Journal of Clinical & Experimental Neuropsychology. CB is an Associate Professor of PM&R at Spaulding Rehabilitation Hospital/Harvard Medical School and Chief Medical Officer at Spaulding Rehabilitation Hospital. She receives grant funding from the US Center for Disease Control and Prevention and the US National Institute on Disability, Independent Living and Rehabilitation Research. She serves on the Board of Directors of the United States Olympic & Paralympic Committee (unpaid) as well as the International Paralympic Committee Medical Committee (unpaid) and the International Olympic Committee Medical & Scientific Commission (unpaid). She serves as an Associate Editor of the British Journal of Sports Medicine (unpaid) as well as the PM&R Journal (unpaid). BLB reports grants from the National Institute on Aging and National Institute of Neurological Disorders and Stroke and honoraria and travel reimbursement for conference presentations. SB: Current or past research funding from the National Institutes of Health; Centers for Disease Control and Prevention; Department of Defense - USA Medical Research Acquisition Activity, National Collegiate Athletic Association; National Athletic Trainers’ Association Foundation; National Football League/Under Armour/GE; Simbex; and Elmind A. He has consulted for US Soccer (paid), US Cycling (unpaid), University of Calgary SH Red Concussions external advisory board (unpaid), medico-legal litigation and received speaker honorarium and travel reimbursements (including CISG) for talks given. He is co-author of “Biomechanics of Injury (3rd edition)” and has a patent pending on “Brain Metabolism Monitoring Through CCO Measurements Using All-Fiber-Integrated Super-Continuum Source” (US Application No. 17/164,490). He is on the and is/was on the editorial boards (all unpaid) for Journal of Athletic Training (2015 to present), Concussion (2014 to present), Athletic Training & Sports Health Care (2008 to present), British Journal of Sports Medicine (2008 to2019) JMB is a part time employee of the National Hockey League and a member of the NHL/NHLPA Concussion subcommittee. He is the neuropsychology consultant to Major League Soccer's Sporting KC. He has served as a consultant to Eye Guide. JSB is supported by the University of Calgary, the Natural Sciences and Engineering Research Council [CGSD3-559333- 2021] and an honorarium for the methods author work associated with Reviews two and four. GAG: Reports grant funding from CDC TEAM and OnTRACK grants, NIMH APNA grant, royalties from PAR, consulting fees from NFL Baltimore Ravens, Zogenix International, and Global Pharma Consultancy and travel support for professional meetings. He is a member of USA Football Medical Advisory Panel. CCG: discloses the following: Grants/Research Support: Hit-IQ (2022-2023); NIH NINDS (R01 NS110757 2019-2024); NINDS (U54 NS121688 2021-2026); UCLA Brain Injury Research Center, UCLA Steve Tisch Brain SPORT program, Easton Clinic for Brain Health Clinical Consultant (provide clinical care to athletes): NBA, NFL-Neurological Care Program, NHL/NHLPA, Los Angeles Lakers Advisory Board (Non compensated): Major League Soccer, National Basketball Association, US Soccer Federation. Advisory Board (Compensated): Highmark Interactive Medicolegal: One or two cases annually Speaker’s Bureau: None. Stock Shareholder: Highmark Interactive stock options (2018). Other Financial or Material Support: Book royalties – Blackwell/Wiley Publishing: Prioritized Neurological Differential Diagnosis Other: None. KMG has received grant funding from NFL for the NFL LONG study. He also serves on the NCAA Scientific Advisory Board in an unpaid capacity. KGH: Research Development Director, Pac-12 Conference Member, Pac-12 Brain Trauma Task Force Member, NFL Head Neck and Spine Committee Deputy Editor, British Journal of Sports Medicine Head Football Physician, University of Washington SH: Co-founder and senior advisor, The Sports Institute at UW Medicine Centers for Disease Control and Prevention and National Center for Injury Prevention and Control Board Pediatric Mild Traumatic Brain Injury Guideline Workgroup NCAA Concussion Safety Advisory Group Team Physician, Seattle Mariners Former Team Physician, Seattle Seahawks MM: Sport and exercise medicine physician working in private consulting practice. Shareholder of Olympic Park Sports Medicine Centre in Melbourne. Ex-senior physician at the Hawthorn Football Club (AFL) Ex-Chief Executive Officer of the AFL Doctors Association. Research grants received from the Australian Football League, outside the submitted work. Travel support received from the Australian Football League, FIFA and the International Olympic Committee to attend and present at international conferences. Member of the Scientific Committee for the 6th International Consensus Conference on Concussion in Sport. Honorary member of the International Concussion in Sport Group. Honorary member of the Australian Rugby Union Concussion Advisory Group. Independent Concussion Consultant for World Rugby. CLM reports no financial COI Volunteer positions: Concussion team physician, Shipley School Board of Trustees, American College of Sports Medicine Board of Directors, American Medical Society for Sports Medicine Board of Directors, Pediatric Research in Sports Medicine Executive Committee, Council on Sports Medicine and Fitness, American Academy of Pediatrics Advisory Board, Untold Foundation, Pink Concussions, Headway Foundation Editorial Board, Journal of Adolescent Health, Frontiers in Neuroergonomics, Exercise, Sport and Movement MMc: has received research funding to the Medical College of Wisconsin from the National Institutes of Health, Department of Veterans Affairs, Centers for Disease Control and Prevention, Department of Defense, National Collegiate Athletic Association, National Football League and Abbott Laboratories. He receives book royalties from Oxford University Press. He serves as clinical consultant to Milwaukee Bucks, Milwaukee Brewers and Green Bay Packers and is Co-Director of the NFL Neuropsychology Consultants without compensation. He serves as consultant for Neurotrauma Sciences, Inc. He receives travel support and speaker honorariums for professional activities. TCV is a paid member of the NFL Head, Neck and Spine Committee and an unpaid member of the USA Swimming Concussion Task Force. WPM: receives royalties from ABC-Clio publishing for the sale of the books, Kids, Sports and Concussion: A guide for coaches and parents, and Concussions; from Springer International for the book Head and Neck Injuries in Young Athlete; and from Wolters Kluwer for working as an author for UpToDate. His research is funded, in part, by philanthropic support from the National Hockey League Alumni Association through the Corey C Griffin Pro-Am Tournament and a grant from a grant from the National Football League. DN: CMO, Canadian Football League (CFL) Medical Director, Edmonton Oilers Hockey Club, National Hockey League Medial Director, Edmonton Elks Football Club, CFL. JP: Editor BJSM (honorarium), Member of World Rugby Concussion Advisory Group (unpaid), Independent Concussion Consultant for World Rugby (fee per consultation), Medical consultant to South African Rugby (unpaid), Co-chair of the Scientific Committee, 6th International Conference on Concussion in Sport (unpaid), Board member of the Concussion in Sport Group (unpaid), Scientific Board member, EyeGuideTM (unpaid). LKP: CASEM Board Member, President-Elect 2022-2023 NIH R34 Grant for EPICC Study (Eye Problems In Concussed Children), Site PI, Speaker at various conferences. MP declares the following: Consultant, CMO, Major League Soccer, Senior Advisor, NFL Head, Neck & Spine Committee, FA Research Task Force Committee member, UK Concussion Foundation Protocol Forum, US Soccer Medical Advisory Commioee, CDC Concussion Consultant, Concussion in Sport Group expert panel, NOCSAE Scientific Advisory Commioee, IOC Mental Health Working Group, USOPC Mental Health Advisory Committee, Team Physician, US Soccer, Received funding for research; NCAA-CARE-DoD 2.0, ended 2020, have received honoraria and reimbursement for travel for speaking and conferences attended, have written chapters for UpToDate and received royalties for the Netter’s Sports Medicine textbook, have provided work as an expert for cases involving concussion, team physician and other sports medicine topics. KJS: has received grant funding from the Canadian Institutes of Health Research, National Football League Scientific Advisory Board, International Olympic Committee Medical and Scientific Research Fund, World Rugby, Mitacs Accelerate, University of Calgary) with funds paid to her institution and not to her personally. She is an Associate Editor of BJSM (unpaid) and has received travel and accommodation support for meetings where she has presented. She is coordinating the writing of the systematic reviews that will inform the 6th International Consensus on Concussion in Sport, for which she has received an educational grant to assist with the administrative costs associated with the writing of the reviews. She is a member of the AFL Concussion Scientific Committee (unpaid position) and Brain Canada (unpaid positions). She works as a physiotherapy consultant and treats athletes of all levels of sport from grass roots to professional. SRW reports receipt of honorarium from the National Athletic Trainers' Association (NATA) for presentation and travel to the 2022 World Congress of the World Federation of Athletic Training and Therapy (WFATT). Dr Walton serves as the Chair of Marketing and Promotions for the WFATT and as a member of the Outcomes working group for the International Initiative for Traumatic Brain Injury Research (InTBIR). Dr Walton reports work on research projects funded by the National Football League (NFL), National Collegiate Athletic Association (NCAA), Department of Defense (DoD) and Department of Veterans Affairs in the United States and these entities do not oversee or provide input on his research or service efforts. KOY: is editor-in-chief of the journal Neuropsychology and receives an editorial stipend from the American Psychological Association. He is an unpaid consulting editor for the journals Archives of Clinical Neuropsychology and Journal of Head Trauma Rehabilitation. He is an unpaid member of the Scientific Advisory Committee for Brain Injury Canada. He is the chair of the Canadian Concussion Network, which is funded by a grant from Canadian Institutes of Health Research (CIHR) to his institution; he is principal applicant on the grant but receives no income from it. He is a principal investigator on another grant from CIHR from which he derives no income. He is a coinvestigator on research grants from CIHR, the US National Institutes of Health (NIH), Brain Canada Foundation and National Football League Scientific Advisory Board; he derives income only from the grant from NIH. He serves as a member of a CIHR grant review panel for which he receives a small honorarium. He receives book royalties from Guilford Press and Cambridge University Press. He has received travel support and honorarium for presentations to multiple organisations. He served or serves on the following committees/boards for which he received honorarium: 1. Independent Data Monitoring Committee (IDMC), Care for Post-Concussive Symptoms Effectiveness (CARE4PCS-2) Trial, National Institute for Child Health and Human Development 2. Observational Study Monitoring Board (OSMB), Approaches and Decisions in Acute Pediatric TBI (ADAPT) Trial, National Institute of Neurological Disorders and Stroke National Research Advisory Council, National Pediatric Rehabilitation Resource Center, Center for Pediatric Rehabilitation: Growing Research, Education and Sharing Science (C-PROGRESS), Virginia Tech University. RZ has current or past competitively-funded research grants from Canadian Institutes of Health Research (CIHR), National Institutes of Health (NIH), Health Canada, Ontario Neurotrauma Foundation (ONF), Ontario Ministry of Health, Physician Services Incorporated (PSI) Foundation, CHEO Foundation, University of Ottawa Brain and Mind Research Institute, Ontario Brain Institute (OBI) and Ontario SPOR Support Unit (OSSU) and the National Football League (NFL) Scientific Advisory Board. He holds Clinical Research Chair in Pediatric Concussion from University of Ottawa and is on the advisory board for Parachute Canada (a non-profit injury prevention charity) and the board of directors for the North American Brain Injury Society (unpaid). He is the co-founder, Scientific Director and a minority shareholder in 360 Concussion Care, an inter disciplinary concussion clinic.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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