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11.27 Level the playing field: exploring barriers to concussion practices for athletes with intellectual disabilities
  1. Catherine McGill1,2,
  2. Meredith Madden1,3,
  3. Andrew Lincoln1,4,
  4. Gina Piccolini-DeSalvo1,5,
  5. Anne Blackstone1,6,
  6. Patricia Kelshaw1,7,
  7. Shane Caswell1,6
  1. 1Virginia Concussion Initiative, George Mason University, Manassas, USA
  2. 2MGill Neuropsychology, MLean, USA
  3. 3Special Olympics Maine, South Portland, USA
  4. 4Special Olympics International, Washington, DC, USA
  5. 5Educational Success Alliance, LLC, Annandale, USA
  6. 6Sports Medicine Assessment, Research and Testing Laboratory, George Mason University, Manassas, USA
  7. 7University of New Hampshire, Durham, USA

Abstract

Objective To explore Special Olympics North America (SONA) coaches’ perceptions of barriers to concussion recognition and response among athletes with intellectual disabilities (ID).

Design Cross-sectional electronic survey.

Setting Community and school-based teams.

Participants SONA volunteer coaches (n=64) across 10 states.

Outcome Measures 21 select-all, Likert-type, and open-ended items related to Health Belief Model constructs. Analyses included descriptive statistics, and a qualitative review of open-ended items using a grounded theory approach.

Main Results Forty-three percent of respondents believe concussions are under-reported in SONA. Five themes emerged regarding challenges to concussion practices: 1) athlete communication barriers, including the ability to identify and initiate report of symptoms; 2) coach differentiation of concussion signs from baseline; 3) under-recognition and under-reporting of concussion signs and symptoms; 4) availability of healthcare providers (HCP) experienced in caring for persons with ID; 5) validated concussion assessment tools.

Conclusions Recognition of concussions among athletes with ID is especially complex. We identified barriers to quality concussion care and reliable concussion identification due to challenges with athlete communication when reporting symptoms, the coach’s ability to accurately differentiate post-injury signs and symptoms, and HCPs’ experience in caring for persons with ID. To reduce health disparities and decrease the risk of poor health outcomes, future education, practice, and research should address concussion policies and procedures to meet the unique needs of athletes with ID and organizations that offer opportunities to participate in athletics. A neurodiversity concussion toolkit is under development to better support athletes, coaches, and HCPs in concussion recognition and response.

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