Parent and Youth Athlete Perceptions of Concussion Injury: Establishing a Factor Structure.

OBJECTIVE: The first objective was to establish the respective factor structures of a concussion perceptions inventory that was adapted for youth athletes (ages 8-14 years) and their parents from the Perceptions of Concussion Inventory for Athletes. The second objective was to understand the associations between the concussion perceptions of youth athlete-parent dyads. METHOD: In this cross-sectional study, 329 parent-youth athlete dyads completed a respective concussion perception inventory. Mean age of youth respondents was 10.9 ± 1.8 years (70.1% male) and mean age of parent respondents was 40.5 ± 13.6 years (60.9% female). RESULTS: Exploratory factor analyses revealed unique 7-factor structures for both the youth athlete and parent inventories (youth athlete: anxiety, clarity, treatment, permanent injury, symptom variability, long-term outcomes, and personal control; parent: anxiety, clarity, treatment, permanent injury, symptom variability, and long-term outcomes, and affect others). Weak associations were found between dyads on the 5 factors that were composed of identical items (anxiety, clarity, treatment, permanent injury, and symptom variability). CONCLUSIONS: Findings suggest that this adapted inventory has adequate psychometric properties to be used in the study of the concussion perceptions of youth athletes and their parents. Weak correlations across the concussion perceptions in the dyads suggest that parents and children hold different concussion perceptions and this should be considered in instrument selection of future studies.

Agreement between parent reported and child self-reported sport-related concussion history: A brief report.

This cross sectional investigation measured the agreement between parent report of their 8-14 year old child's sport-related concussion (SRC) history and their child's self-report of their own SRC history. Parent-child dyads (n = 405) within a youth contact sports (e.g., football, ice hockey, lacrosse, soccer) setting participated in the study. Parents (6.2%) and 8.6% of children self-reported a history of at least one diagnosed SRC. We observed substantial agreement between the number of parent-reported and child self-reported SRCs (κ = 0.613, p ≤ .001). Partial agreement regarding the number of SRCs reported by both groups was also substantial (weighted κ = 0.693, p ≤ .001). Removing dyads where neither the parent nor the child reported a diagnosed SRC, sensitivity analyses revealed only fair agreement in parent-child SRC recall. These results indicate that parents and youth athletes overall accounts of their diagnosed SRC history correspond. However determining specifics (e.g., total concussion counts) may benefit from concurrent parent reports, or documented events in medical histories.

A virtual adaptation of the taped problems intervention for increasing math fact fluency.

In response to restrictions on visitors within school buildings during the COVID-19 pandemic, the evidence-based math fact fluency procedure known as the taped problems intervention was adapted for use in a virtual setting. The present study used a multiple-probe across participants design to evaluate the effects of the adapted intervention on the subtraction fact fluency of three elementary school students with varying degrees of math difficulties. Researchers also measured whether fluency gains would generalize to subtraction fact family problems that were not targeted within the study procedures. Visual analysis of results indicated math fluency improvements across all students, regardless of initial performance level, but no evidence of generalization effects for any participant. Additionally, to further investigate intervention effects, two effect size measures were calculated (WC-SMD and NAP) and each participant's rate of improvement was measured in two ways. Slopes (digits correct per minute [DCM] gains per session) of baseline and intervention phases were compared, and DCM gains per intervention time were investigated. Discussion focuses on implications for providing academic interventions in virtual learning environments, the importance of direct instruction for subtraction fact fluency, as well as future directions for researchers. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Factors associated with parent and youth athlete concussion knowledge.

INTRODUCTION: On-site health care providers are not routinely present at all youth sport events. Therefore, parents and youth athletes are often responsible for identifying and making appropriate immediate care decisions regarding concussions, which may be influenced by their injury health literacy. Previous studies have investigated the level of concussion knowledge of parents and athletes, but few have investigated factors associated with greater awareness at the youth sport level specifically. METHOD: A total of 466 parents and 390 youth contact sport athletes from Pennsylvania and Michigan completed separate surveys of concussion knowledge and personal and family demographic information. RESULTS: Parents had a mean concussion knowledge score of 39.3 ±â€¯4.6 out of a possible 47 points. Having a medical occupation (p = .04) and being older in age (p = .03) were associated with higher concussion knowledge scores in parents (R2 = 0.018; 95% CI = 32.77-38.99). Youth athletes had a mean concussion knowledge score of 35.0 ±â€¯5.7 out of 47. Having learned about concussion previously (p < .001), having a history of diagnosed concussion(s) (p = .01), sport type (relative to girls' ice hockey, p < .001), older age (p < .001), and parent concussion knowledge (p = .04) were associated with higher youth athlete concussion knowledge (R2 = 0.176; 95% CI = 19.08-31.72). CONCLUSIONS: More evidence-based concussion awareness resources are needed at the youth sport level. While it did not significantly influence concussion knowledge for parents, concussion education is a modifiable factor that may be essential for improving concussion knowledge of youth athletes, thus warranting further study into effective awareness strategies for this population. Practical Applications: The factors found to influence concussion knowledge in this study could be considered in future educational concussion initiatives for youth athletes and their parents in order to increase awareness regarding the potential dangers of participating in sport while concussed.

Concussion Nondisclosure in Youth Sports.

CONTEXT: Researchers conducting studies about sport-related concussion (SRC) reporting behaviors and reasons for nondisclosure primarily focus on older athletic populations. Youth athletes participating in contact sports are also at risk for SRC; however, little is known about their SRC disclosure patterns and reasons for nondisclosure. OBJECTIVE: To examine the self-reported SRC history and reasons for SRC nondisclosure of youth athletes aged 8-14 years. DESIGN: Cross-sectional study. SETTING: Youth athletes in organized football, ice hockey, lacrosse, or soccer. PATIENTS OR OTHER PARTICIPANTS: A total of 411 youth athletes (boys = 70.0% [n = 287/410]; median age = 11 [interquartile range = 10-13] years). MAIN OUTCOME MEASURE(S): A 15-minute survey including self-reported demographics, diagnosed and nondisclosed SRC history, and reasons for nondisclosure of suspected SRCs. RESULTS: Ten percent of respondents (n = 41/411) recounted ≥1 diagnosed SRC, 12.7% (n = 52/411) did not report a suspected SRC, 13.1% (n = 53/404) indicated they continued to practice, and 12.3% (n = 50/406) reported they continued to play in a game after a suspected SRC. Significant associations between sport and nondisclosure existed (P values < .001) but not with self-reported concussion history (P = .14). In sex-comparable analyses, boys' lacrosse players had a higher frequency of nondisclosure than girls (P = .05). The most common reasons for nondisclosure were not wanting to lose playing time (66.7%, n = 32/48), miss a game (56.3%, n = 27/48), and let the team down (43.8%, n = 21/48) and uncertainty over injury severity and the presence of SRC (43.8%, n = 21/48). CONCLUSIONS: Ten percent of youth athletes self-reported at least 1 diagnosed SRC. However, they also described continuing to practice or play in a game after a suspected SRC. Reasons for nondisclosure at this age were similar to those reported in high school and collegiate athletes. Recent researchers suggested negative consequences of continued play with SRC, especially in the acute stages. Anyone conducting future educational initiatives should emphasize these risks and focus on reasons why athletes of both sexes withhold reporting.

Diagnosed and Nondisclosed Sport-Related Concussion: An Exploratory Comparison Study by ADHD Status in Collegiate Athletes.

OBJECTIVE: To determine if ADHD status in collegiate athletes was associated with differences in the number of diagnosed and nondisclosed sport-related concussions, and reasons why suspected concussive injuries were not reported. METHOD: A cross-sectional survey was completed by 858 collegiate athletes (65 with ADHD; 793 without ADHD). The survey included self-report items regarding ADHD status and histories of diagnosed and nondisclosed sport-related concussions. Groups were matched for gender, age, and sport with a ratio of one participant with ADHD to four without ADHD. RESULTS: Collegiate athletes with ADHD reported significantly more diagnosed sport-related concussions and were more likely to have a history of diagnosis compared to those without ADHD. There were no significant differences between groups regarding sport-related concussion nondisclosure history. CONCLUSION: Collegiate athletes with ADHD have an increased prevalence rate of diagnosed sport-related concussions compared to those without ADHD; however, this developmental disorder may not influence injury nondisclosure decisions.

Anxiety-related concussion perceptions of collegiate athletes.

OBJECTIVES: The purpose of this study was to identify collegiate athletes' anxiety-related concussion perceptions and examine factors that may be related to increased anxiety injury beliefs. DESIGN: Cross-sectional study. METHODS: Male and female Division I, II and III NCAA collegiate athletes (n = 482) completed a 10- to 15-minute survey examining their demographics, diagnosed concussion history, concussion knowledge, and public media sources they have previously acquired concussion information from. The survey also included the Perceptions of Concussion Inventory for Athletes (PCI-A) which results in six outcome variables (anxiety, effects, control, clarity, treatment, and symptom variability). Univariable and a backward stepwise multivariable logistic regression model were utilized to identify variables that were associated with greater (above median) negative anxiety-related concussion perception scores. RESULTS: Collegiate athletes displayed moderate anxiety-related concussion perceptions (12.8 ±â€¯3.2; scores ranged from 4 - low anxiety to 20 - high anxiety). The majority of participants reported that concussions are upsetting to them (60.7%), with a sizable proportion being worried (46.7%), fearful (40.7%), or anxious (25.0%) about sustaining a concussion. In the multivariable regression, higher perception that concussions have long-term effects (OR = 2.72; 95% CI: 1.79-4.12), greater beliefs of internal control to influence concussion outcomes (OR = 1.78; 95% CI: 1.15-2.75), and female sex (OR = 1.77; 95% CI: 1.15-2.71) were associated with higher anxiety beliefs. CONCLUSIONS: This study for the first time establishes that negative, anxiety-related perceptions about concussions are prevalent in a collegiate athlete population. Addressing these perceptions through evidence-based, educational and management initiatives, such as highlighting that concussions are treatable and most do not result in long-term negative consequences with early diagnosis and proper management, are critical to improve emotions surrounding concussion. This may be particularly important for female athletes in this population.

Development and factor structure of the perceptions of concussion inventory for athletes (PCI-A).

Purpose: This study evaluated the factor structure of the Perceptions of Concussion Inventory for Athletes (PCI-A) using exploratory factor analytic (EFA) techniques in a sample of collegiate student-athletes. Perception differences by sex and sport-related concussion (SRC) risk level were explored.Methods: This cross-sectional-design study included 298 male and 183 female collegiate student-athletes from 18 sports at six institutions. Participants completed a demographic and concussion history survey, and the PCI-A.Results: The EFA revealed a 6-factor solution (Anxiety, Effects, Clarity, Treatment, Control, and Symptom Variability) that accounted for 56.1% of the variance in responses. Female collegiate student-athletes displayed statistically higher levels of Anxiety, Clarity, Symptom Variability, and Control than males. Lower concussion risk sport athletes reported statistically higher levels of anxiety surrounding SRC and concerns relating to the long-term and major effects of an SRC.Conclusions: This study provides evidence that the PCI-A is an acceptable measure to examine the perceptions of collegiate student-athletes regarding SRC. The findings supported a six-factor structure of the PCI-A in the current study for collegiate student-athletes compared to the seven-factor structure indicated in previous research. The findings reveal sex and concussion risk sport differences in PCI-A responses.

Current status of pediatric topics in five school psychology journals: Publication trends between 2002 and 2019.

The American Psychological Association and the National Association of School Psychologists agree in parallel calls for school psychologists to develop pediatric-related competencies. To achieve these competencies, trainers and practitioners require a suitably supportive literature. Ideally, this literature would link pediatric knowledge to school-based practice and address evidence-based assessment and intervention. The present article updates prior research (Wodrich & Schmitt, 2003) on this topic by addressing the rate at which pediatric-related topics were published between 2002 and 2019 in five key journals: Journal of School Psychology, Psychology in the Schools, School Psychology International, School Psychology Review, and School Psychology Quarterly. To establish publication trends across time and to extend the earlier research, articles were first coded as either empirical or nonempirical, then coded further according to content (i.e., attention-deficit/hyperactivity disorder [ADHD], a pediatric condition [other than ADHD], professional role issue). The empirical subset of articles was additionally coded according to assessment, intervention, or general knowledge foci. The category comprising the greatest number of articles was pediatric condition (n = 121), followed by ADHD (n = 108) and professional role issue (n = 18). The most specific, commonly appearing pediatric topic was ADHD, as was true when the 2003 article was published, with a surge in empirical ADHD articles noted. The least common topic was pediatric professional role issues. Current trends highlight a need for future empirical articles related to assessment and, particularly, school-based intervention for non-ADHD pediatric health conditions. Limitations of the present research are also discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Speech-to-text assistive technology for the written expression of students with traumatic brain injuries: A single case experimental study.

Traumatic brain injury in childhood (TBI) is a chronic health condition. As decreased memory, language, and rapid psychomotor impairments are known to accompany pediatric TBI (Babikian et al., 2011), students who have experienced a moderate-to-severe TBI are at particular risk for academic deficits, including writing difficulties. The purpose of this study was to measure the effects of a speech-to-text assistive technology (AT) accommodation that was implemented to bypass the impaired handwriting and spelling (i.e., transcription) skills resulting from TBI. Three African American male students (Grades 4, 8, and 9) who received formal special education services under the category of TBI participated in this study. With the application of the speech-to-text AT accommodation, all participants' total words written (TWW), words spelled correctly (WSC), and correct writing sequences (CWS) significantly increased compared to the handwriting control condition. One hundred percent nonoverlapping data points across participants and dependent variables was achieved. Implications of the findings for the school-based treatment of TBI, study limitations, and future avenues of study are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The effects of two assistive technologies on reading comprehension accuracy and rate.

This study compared the effectiveness of two assistive technologies to accommodate the word reading skills of four middle school students with reading learning disabilities. Kurzweil 3000 is a continuous text-to-speech (TTS) computer software program that allows students to follow along on a computer monitor while passages are read aloud. A reading pen is a discontinuous TTS assistive technology (AT) device that allows students to scan and hear selected words read aloud. An adapted alternating treatments design was implemented to compare the effects of listening-while-reading using continuous TTS AT, discontinuous TTS AT, and silently reading without accommodation on reading comprehension accuracy and rate. Results indicate that in three of the four participants, continuous TTS technology led to the greatest improvements in both comprehension accuracy and rate when compared to silent reading with effect sizes reaching 0.70 and 0.99, respectively. The fourth participant demonstrated the highest comprehension accuracy and rate in the discontinuous TTS condition. The discontinuous TTS condition led to the lowest comprehension rates across all four students. Additionally, participants generally found the continuous TTS AT to be the more acceptable of the two accommodations. Discussion focuses on possible theoretical explanations for the results and implications for future research.

Validation of a Developmental Neuropsychological Assessment (NEPSY) through comparison of neurological, scholastic concerns, and control groups.

Validity of the standard, 13 subtest A Developmental Neuropsychological Assessment (NEPSY) was investigated by comparing scores for 30 children with neurological conditions, 35 children with scholastic concerns, and 39 controls. Overall differences were found among the groups with and without controlling for IQ (Lambda = .60, Lambda = .001; Lambda = .70, P < .001). Four of five NEPSY domain scores differed among the three groups. Language and Sensorimotor domain score differences were found even when IQ was controlled, and group status accounted for substantial variance in these domain scores. Regarding specific tasks, Phonological Processing and Fingertip Tapping were among the subtests that varied the most between groups, especially when children with scholastic concerns were compared with controls. Findings offer preliminary support for the validity of several NEPSY indexes.