Objective: To explore the prognostic ability of the vestibular/ocular motor screening (VOMS), King-Devick (K-D) Test, and C3 Logix Trails A and B to identify protracted recovery from sports-related concussion (SRC) in patients aged 8 to 12 years. Design: Retrospective cohort analysis. Setting: Specialty pediatric sports concussion clinic. Participants: A total of 114 youth athletes aged 8 to 12 years who were diagnosed with an SRC within 7 days of injury. Independent Variables: A positive screen on the VOMS, K-D, and C3 Logix Trails A and Trails B. Combined positive screens on multiple tests (ie, 2, 3, or all 4 positive screens of 4 possible). Main Outcome Measures: Recovery time in days and protracted recovery (recovery time $30-days) were the primary outcomes of interest. Results: A positive VOMS screen was associated with 1.31 greater days to SRC recovery (P 5 0.02) than a negative VOMS screen. The K-D and C3 Logix tests were not significantly associated with recovery time, nor were any combinations of tests (P . 0.05). The VOMS demonstrated moderate prognostic ability to predict normal recovery (negative predictive value 5 80.78% [95% CI 5 63.73-90.95]). Overall predictive accuracy of normal versus protracted recovery was strongest when a participant screened positive on all 4 tests (Accuracy 5 76.32% [95% CI 5 67.45-83.78]). Conclusions: The VOMS was associated with overall recovery time and proved to be a useful test to identify those who would experience a normal recovery time. Combining the 4 tests improved the prognostic accuracy of the protocol in predicting protracted versus normal recovery. These findings suggest that combining multiple, varied assessments of cognition and vestibular/ocular functions may better explain factors contributing to protracted recovery.

Objectives: To conduct a systematic review of recent pediatric Down syndrome (DS) neuropsychology research that may be useful to clinicians and researchers examining regression in this population. Methods: We reviewed original peer-reviewed articles published between 2013 and 2018 studying neuropsychological profiles in DS. Results: Thirty-one articles (of 1231 included in the original search) passed all inclusion criteria, were evaluated for bias, and were included in the analysis. Conclusion: Findings argued against a single “DS profile” and revealed multiple within-group differences as well as expected and unexpected differences relative to typically developing children and children with other intellectual and developmental disabilities. Areas identified as most germane to regression monitoring included working memory, inhibition, letter and word identification, navigational route learning, motor skills (when strong at baseline), single word receptive/expressive vocabulary, and adaptive function.

Background: Sports-related concussions (SRCs) are a concern for youth athletes and their subsequent healthy development into adulthood. Protracted recovery (>28 days) from a SRC may lead to long-term complications resultant of persistent symptoms. There is a current lack in understanding of the factors contributing to protracted recovery from SRC in children, and in particular no tools exist to identify those SRC patients that may be more likely have a protracted recovery in an acute clinical setting. Hypothesis/Purpose: To examine the relationship between initial Vestibular and Ocular Motor Screening (VOMS) and protracted recovery from concussion in youth. Methods: Children aged 8-12 years old, who were diagnosed with a SRC and seen in a concussion specialty clinic within 7-days of injury were included in the analysis. VOMS was administered during the initial visit. A positive VOMS score was defined as any 2-point increase from baseline in patient reported symptom severity on dizziness, fogginess, headache, and nausea, or any convergence measure greater than 6 centimeters. Recovery time (days) was the interval between date of injury and date of medical clearance. Multivariable logistic regressions were used to determine the odds of protracted recovery based on an initial positive VOMS. Results: A total of 108 males (mean age=10.8, sd=1.3) and 66 females (mean age=10.8, sd=1.4), took a median (IQR) 20.0 (15.0-28.5) and 22.0 (15.0-34.0) days to recover, respectively. After controlling for age and days since injury, those with a positive VOMS were 3.92 (95% CI = 1.58-9.71, p=0.003) times more likely to have a protracted recovery compared to those with a negative VOMS. When stratified by sex, observed effects were more amplified among males (OR=5.92, 95% CI=1.59-21.96, p=0.008), than among females (OR=2.44, 95% CI=0.61-9.71, p=0.21). Conclusion: There is a need to determine the relationship between SRC assessment measures and recovery time to improve clinical management and outcomes. In this sample of pediatric concussion patients aged 8-12 years, the VOMS displayed potential as a tool to screen for delayed recovery among males. Future studies should confirm these findings in other, larger samples, while taking into consideration other factors that may influence recovery time.