Topics in Language Disorders

From the Editors: Concussion: Progress and Challenges in Identification, Assessment, and Management No abstract available

Issue Editor Foreword: Concussion: Challenges and Opportunities in Identification, Assessment, and Management No abstract available

Evaluating Cognitive-Linguistic Deficits Postconcussion in Adults: Contributions of Self-Report and Standardized Measures Purpose: We sought to document the cognitive-linguistic challenges experienced by 3 adults with concussion at varying lengths postinjury. Method: A multiple case study design utilized motivational interviewing techniques, 4 self-report measurement tools, and 5 standardized neurocognitive tests. The 1 female and 2 male participants were 1, 21, and 37 months postconcussion. Results: All participants self-reported cognitive and linguistic challenges significantly impacting daily functioning and quality of life. Cognitively, participants demonstrated deficits in independence, metacognition, and cognitive flexibility. Linguistically, participants demonstrated deficits in verbal memory, verbal fluency, and reading. The participant 1-month postconcussion demonstrated deficits on multiple standardized measures; however, participants in the chronic phase of recovery demonstrated substantially more self-reported deficits than were noted on standardized testing. Discussion: Evaluation of cognitive-linguistic deficits postconcussion requires both self-report and standardized measurement; however, limitations of both tools exist. We discuss clinical implications for professionals selecting testing measures for use in this population.

Management and Recovery Patterns Following Sport-Related Mild Traumatic Brain Injury in Male and Female College Athletes Purpose: We examined patterns in mild traumatic brain injury (mTBI) management and recovery exhibited by male and female athletes over the 19-year history of a Division 1 University Concussion Management Program. Methods: We examined 234 diagnosed mTBIs and compared time required to return to baseline on neurocognitive and self-report symptom measures for male and female athletes. Results: Males and females sustained 63.3% and 36.7% of mTBI, respectively. Athletes required on average 11.89 days to return to baseline on neurocognitive assessments and 11.83 days to report being symptom-free. There was a significant difference in the number of days until genders were symptom-free, with males and females requiring on average 10.11 days and 14.30 days, respectively. Discussion: More collegiate athletes received pre- and post-mTBI management than in the past. There is a continued need to examine patterns of neurocognitive and symptom recovery, which may lead to earlier detection of athletes at risk for persistent post-mTBI symptoms.

The Risk for Traumatic Brain Injury and Persisting Symptomatology in Elementary, Secondary, and University-Level Students: An International Perspective With the Greek Version of the Brain Injury Screening Questionnaire Purpose: This study is part of the first systematic program in the Republic of Cyprus examining the prevalence of traumatic brain injury (TBI) in children, teenagers, and university students. The study incorporated the Greek Version of the Brain Injury Screening Questionnaire (BISQ-G) as the primary tool to identify students with TBI. Methods: The BISQ-G was sent out to 2,800 families of children (aged 6–18 years) attending rural and urban elementary and secondary schools from varied socioeconomic backgrounds. Nine hundred forty-four questionnaires (33.8%) were returned. In addition to school-aged children, 322 university students (aged 17–25 years) were recruited from 3 universities and completed the BISQ-G. Results: Analyses indicated that 5.8% elementary, 9.7% secondary, and 22.7% university students had symptoms consistent with TBI. Several participants reported more than 1 TBI. Etiology of TBI was similar in all 3 groups and included sports, biking, and falls. Factor analyses yielded a 7-factor structure for the BISQ-G. Discussion/Conclusions: The BISQ-G is a valid tool for the identification of individuals with a prior history of TBI. Causes and symptoms of TBI were similar to those reported in the international literature. The article concludes with suggestions for TBI management in the schools.

Looking Beyond Test Results: Interprofessional Collaborative Management of Persistent Mild Traumatic Brain Injury Symptoms Patients with cognitive concerns following mild traumatic brain injury (mTBI), often referred to as concussion, present with complex constellations of strengths and limitations. Increasing evidence indicates that psychosocial factors, as opposed to the injury itself, predict persistent symptoms. As an alternative to the traditional medical model, a person-centered model empowers the patient to move forward past the injury in order to optimize function and maximize quality of life. Patient-centered assessment and treatment by speech–language pathologists, neuropsychologists, and rehabilitation psychologists can engender change, reduce perceived limitations, and increase participation in meaningful activities and roles. This article outlines several collaborative, process-oriented approaches to managing cognitive concerns subsequent to mTBI. The emphasis is on maximizing patient participation to guide clinical decision making and build self-efficacy. The authors are members of the Joint Committee on Interprofessional Relations Between the American Psychological Association (APA) and the American Speech–Language–Hearing Association (ASHA).

A Comparison of Student and Parent Knowledge and Perceived Confidence About Brain Injury and Concussion Purpose: The public has long had misconceptions about traumatic brain injury (TBI) and its effects. Concussion education targeted toward athletes has been increasing with passage of return-to-play laws in all 50 states. The current study examined differences in public knowledge about TBI and concussion, and the extent to which students and parents in the general public may have benefited from increased availability of education around concussion. Methods: At a public fair, 246 students, parents, and other adults completed a survey adapted from existing TBI and concussion knowledge surveys. Participants also rated their confidence in accuracy of their responses. Results: There were no group differences on TBI knowledge or confidence. Parents scored slightly higher on concussion knowledge than students, and knowing someone with a TBI or concussion was also associated with higher scores. Confidence was only weakly related to concussion knowledge. Overall concussion knowledge scores were higher than TBI knowledge scores. Knowledge and confidence were not associated with sports participation. Discussion: Given similarities in TBI knowledge across groups, but that parents outpace students in concussion knowledge, parents may have greater exposure or heightened awareness of concussion information education opportunities. Lower confidence in students suggests an openness to education and opportunities for prevention of injuries.

Continuing Education Instructions and Questions No abstract available