Thesis (M.A.)--Boston University / Sports-related concussions are a very large public health concern and have only recently been brought into the national spotlight, thanks largely to the increased media coverage following the deaths of several current and former players of the National Football League (NFL). This problem extends not only to professional athletes, but reaches down through college, high school and to our youth athletes as well. The symptoms resulting from concussion are diverse and include both acute and long-term effects, and could have particularly debilitating effects on the developing brains of young athletes. Various neurocognitive deficits, as well as neurodegenerative diseases such as chronic traumatic encephalopathy (CTE) have been associated with concussions. Research about both the short and long-term effects of concussions has been growing in recent years, and will continue to grow as advanced neuroimaging tools and biomarkers become better developed. This will improve diagnostic capabilities, result in better prognoses, as well as treatments and prevention. This review analyzes current literature in order to evaluate the lasting impacts of sports-related concussions. By showing the effects of sports-related concussions, especially on the developing brain, policy changes aimed at the prevention of concussion in sports will be suggested, specifically in terms of mitigating the adverse effects of concussions on brain development.

Concussion affects the adolescent population in large numbers, primarily because of the popularity of team sports that are played in middle and high school. This adolescent age group is more susceptible to the adverse effects of concussion due to physiological immaturity, and recovery for this population takes longer than in adults. Speech-language pathologists, who are trained to treat cognitive-communication deficits, are present in the majority of school systems throughout the United States, and could be a useful resource to manage and treat students who incur concussion. However, speech-language pathologists historically have not treated students with concussion, and may not be receiving adequate education regarding concussion in graduate programs. This study sought to ascertain the education, training, and experience regarding concussion of speech-language pathologists in Texas secondary schools. Anonymous survey responses were collected via an Internet survey platform, yielding 49 respondents for the final data pool. The answers provided by these respondents indicate Texas speech-language pathologists are not yet receiving adequate concussion education and training. Respondents reported low confidence levels in several key areas of concussion knowledge, and doubt regarding the speech-language pathologist's role in managing concussion. Recommendations include concussion-targeted graduate school curriculum as an extension of traumatic brain injury curriculum, increased continuing education efforts by ASHA regarding concussion and the speech-language pathologist's role in treating concussion, and further advocacy by ASHA for speech-language pathologists to be part of concussion management teams based in schools. / text

Concussions, attention-deficit disorder (ADHD), and learning disabilities can adversely impact learning and academic achievement, particularly with respect to attention, memory, and executive functioning; fortunately, cognitive training can be beneficial and remediating these weaknesses. One such program, strategic memory advanced reasoning training (SMART), utilizes a top-down approach to train individuals in executive, higher-ordered thinking strategies including strategic attention, integration, and innovation to facilitate information synthesis and enhance cognitive efficiency. Thus, the purpose of the study is to examine whether SMART improved performances on various neuropsychological measures tapping into attention, processing speed, memory, and executive functioning for college student-athletes with neurological conditions (e.g., concussions, ADHD, LD). Student-athletes were randomly assigned to the SMART program or a "wait-list" control group and were administered a neuropsychological battery at baseline, immediately following the intervention, and after a four-month delay. Results showed that participants benefited from SMART with respect to working memory immediately following the intervention after controlling for baseline scores. The benefits of working memory also persisted after four months. Additionally, SMART was beneficial for improving attention, but only after four months after the intervention. The findings of the current study were consistent with previous studies which showed positive effects of SMART on working memory with a variety of populations (e.g., children, adolescents, older adults, Veterans, brain-injured patients); however, the current study did not see improved performance on other aspects of executive functioning which contradict prior research. Statistical differences between the present study and prior research regarding SMART may be explained in methodology, participant characteristics, research setting, and/or limitations. Future studies may include combining cognitive training as the intervention and utilizing neuroimaging alongside cognitive training to examine the relationship between structural/functional change with neuropsychological performance.