Academic Performance Following Sport-Related Concussions in Children and Adolescents: A Scoping Review

Neelakantan, Mekala; Ryali, Brinda; Cabral, Maria Demma; Harris, Ann Marie; McCarroll, Juli; Patel, Dilip R.

doi:10.3390/ijerph17207602

Cited by 25 publications

(17 citation statements)

References 26 publications

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“…They are readily influenced by confirmatory pieces of information (eg, anchoring their opinion based on a referral sent to them that a patient has persistent symptoms and is not improving) and often assume that 2 events occurring around the same time (eg, concussion and academic decline) are causally related even in the absence of supportive and conclusive literature. 62 They then adjust decisions or opinions to fit the data that are collected instead of using the data to accept or refute a hypothesis (ie, a clustering illusion). Past work 63 provides suggestions for how to reduce biases.…”

Section: Stay Abreast Of the Most Recent Research And Evidence-based Recommendationsmentioning

confidence: 99%

The Nocebo Effect and Pediatric Concussion

Kirkwood¹,

Howell²,

Brooks³

et al. 2021

Journal of Sport Rehabilitation

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While placebo effects are well recognized within clinical medicine, “nocebo effects” have received much less attention. Nocebo effects are problems caused by negative expectations derived from information or treatment provided during a clinical interaction. In this review, we examine how nocebo effects may arise following pediatric concussion and how they may worsen symptoms or prolong recovery. We offer several suggestions to prevent, lessen, or eliminate such effects. We provide recommendations for clinicians in the following areas: terminology selection, explicit and implicit messaging to patients, evidence-based recommendations, and awareness of potential biases during clinical interactions. Clinicians should consider the empirically grounded suggestions when approaching the care of pediatric patients with concussion.

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Section: Stay Abreast Of the Most Recent Research And Evidence-based Recommendationsmentioning

confidence: 99%

The Nocebo Effect and Pediatric Concussion

Kirkwood¹,

Howell²,

Brooks³

et al. 2021

Journal of Sport Rehabilitation

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“…Best practices in concussion focus on symptom identification and management with the goal of facilitating a safe resumption of activities, including return-to-learn (RTL) or return-to-school ( Lumba-Brown et al, 2018 ; McCrory et al, 2017 ). However, RTL may be negatively affected by post-concussive symptoms ( Neelakantan et al, 2020 ), and students with more numerous or severe symptoms, including those with persistent symptoms, may experience symptom exacerbation with RTL ( Silverberg et al, 2016 ). Current guidelines also suggest minimizing absence from school, as prolonged rest lengthens recovery time ( Thomas, Apps, Hoffmann, McCrea, & Hammeke, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

“…Students with concussion are at risk for unfavorable short (< 3 months) and long (≥12 months) term academic performance outcomes ( Neelakantan et al, 2020 ), and cognitive demand with RTL may worsen symptoms ( Silverberg et al, 2016 ). Students may also experience psychological impairments such as depression and anxiety immediately or after RTL ( Yrondi, Brauge, LeMen, Arbus, & Pariente, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Physician recommended school accommodations and student outcomes following a mild traumatic brain injury among youth with persistent post-concussive symptoms

Takagi-Stewart

Johnson²,

Smith

et al. 2022

NRE

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BACKGROUND: Post-concussion return-to-learn (RTL) guidelines include implementation of school accommodations. Yet, little is known about physician recommendations for school accommodations and their impact, particularly among youth experiencing persistent post-concussive symptoms (PPCS). OBJECTIVE: We examined the association between physician recommended school accommodations and student outcomes among youth experiencing PPCS. METHODS: Data from a randomized comparative effectiveness trial was used. Physician recommended school accommodations (≤90 days post-injury) were collected via chart abstraction. Grade point average was extracted from school records. Reports of problems at school, concussion symptoms, health-related quality of life (HRQOL), anxiety symptoms, and depressive symptoms were collected by survey (at baseline, three months, and 12 months post study entry). RESULTS: Of 200 participants (Mage = 14.7, 62% female), 86% were recommended school accommodations. Number of recommended school accommodations was positively associated with number of school problems at three months (aRR 1.18, 95% CI:1.12–1.24) and 12 months (aRR 1.11, 95% CI:1.05–1.18). No significant associations were found between recommended school accommodations and GPA, HRQOL, anxiety symptoms, or depressive symptoms. CONCLUSIONS: Physicians recommend more school accommodations for students experiencing more school problems post-concussion. Appropriate implementation of RTL recommendations made by physicians by fostering partnerships among physicians, students, and schools may be needed to achieve student-centered RTL.

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“…1–3 Concussion symptoms include cognitive impairment, prominently problems with attention and processing speed, 4–7 along with emotional and physical problems, and sleep dysregulation all of which can impact academic performance and overall quality of life. 8–10 Most children that experience a concussion recover within two weeks of injury, however, 10-30% of children experience symptoms that last longer than 3 months, 11–13 with females at greater risk of persistent symptoms. 14–16 Little is known about the association between sex-specific effects of concussion on the developing brain and emerging cognitive abilities.…”

Section: Introductionmentioning

confidence: 99%

Premature white matter microstructure in female children with a history of concussion

Nishat

Stojanovski

Scratch

et al. 2021

Preprint

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As maturation of the brain continues throughout development, there is a risk of interference from concussions which are common in childhood. A concussion can cause widespread disruption to axons and inflammation in the brain and may influence emerging cognitive abilities. Females are more likely to experience persistent problems after a concussion, yet the sex-specific impact of concussions on brain microstructure in childhood is not well understood.In children from a large population sample, this study (1) investigated differences in white matter and cortical microstructure between children with and without a history of concussion, and (2) examined relationships between altered brain microstructure and cognitive performance.Neurite density measures from diffusion weighted magnetic resonance imaging were examined in 9-to 10-year-old children in the Adolescent Brain Cognitive Development Study with (n = 336) and without (n = 7368) a history of concussion. (1) Multivariate regression models were used to investigate the relationships between concussion history, sex, and age in the deep white matter, superficial white matter, subcortical structures, and cortex. (2) Principal component analysis was performed on neurite density, and components were examined in relation to performance on the Flanker Inhibitory Control and Attention Task and the Pattern Comparison Processing Speed Task to investigate the relationship between altered neurite density and cognitive performance.Neurite density in all tissue types demonstrated robust positive relationships with age reflecting maturation of brain microstructure. (1) Comparisons between children with and without a history of concussion revealed higher neurite density in deep and superficial white matter in females with concussion. No group differences were observed in subcortical or cortical neurite density. (2) Higher neurite density in superficial white matter beneath the frontal and temporal cortices was associated with lower scores on the processing speed test in females with concussion, and higher scores on the processing speed test in males with concussion.These findings suggest that concussion in childhood leads to premature white matter maturation in females and that this may be associated with slower processing speed. These sex-specific effects on the developing brain may contribute to the enhanced vulnerability to persistent symptoms after concussion in females.

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Academic Performance Following Sport-Related Concussions in Children and Adolescents: A Scoping Review

Cited by 25 publications

References 26 publications

The Nocebo Effect and Pediatric Concussion

The Nocebo Effect and Pediatric Concussion

Physician recommended school accommodations and student outcomes following a mild traumatic brain injury among youth with persistent post-concussive symptoms

Premature white matter microstructure in female children with a history of concussion

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