Effects of Concussion in Adolescent Students: Perceptions and Performance

Abstract

Objective: The purpose of this study was to compare adolescent students with and without concussion on a battery of academic, neurocognitive, and socioemotional measures and assess the aftereffects of concussion across domains of functioning. Methods: Twenty-four adolescents (ages 13–17) reporting postconcussion symptoms were compared to 24 controls matched for age and gender across a battery of tests and surveys. Results: After correcting for multiple comparisons, there were no significant differences on any neuropsychological measures. Similarly, there were no significant group differences on academic measures of vocabulary, word recognition, or reading comprehension. Self-reported concussion symptoms were much greater for students with concussion, as were self-reports of anxiety, depression, and somatization symptoms. Parents also rated those with concussion as having greater depression and somatization symptoms, but not to a degree that survived Bonferroni correction. Lastly, those with concussion reported a significantly greater number of school problems and academic concerns. Conclusions: Results indicated that adolescents who reported postconcussion symptoms do not perform differently from peers on most neurocognitive and academic tasks, yet they showed considerably more worry, somatization, academic concerns, and feelings of inadequacy than matched controls. The findings suggest that interventions to address psychological and academic stress may be indicated for adolescents symptomatic from concussion.

The symptom experience of adolescents with concussion

“…They described how they did not feel like themselves after concussion but found it difficult to explain the feeling. This is consistent with research that found adolescents who experienced a concussion felt something was wrong with them (Rieger, Lewandowski, Potts, & Shea, ). These findings suggest evaluating the effects of the concussion symptoms on adolescents’ lives is important in understanding the symptom experience and developing a management plan.…”

The Nocebo Effect and Pediatric Concussion

“…Providing academic and psychological support when needed during recovery is important, as academic and mood concerns have been associated with persistent symptoms. 44 Failure to treat these contributing factors may lead to continuing symptoms erroneously being attributed to the persistent pathophysiology of concussion. • If a discussion about sport-related catastrophic outcomes is warranted, be sure to put this in proper context and clearly emphasize its rarity.…”

Teachers’ Perceived Knowledge and Confidence Regarding Adolescent Concussion Management

“…In another scenario, a student experiencing difficulty with organizational skills or working memory may benefit from using a planner or following written instructions when completing an assignment (Halstead et al, 2013). The intent of AA is to limit symptom recurrence, but it can also decrease a student's anxiety over missed schoolwork during the recovery process (Ransom et al, 2016;Rieger et al, 2019).…”

“…These support strategies, or academic adjustments (AA), are chosen based on the student's symptoms and functional deficits and are intended to limit symptom exacerbation after the student's re-integration to the school environment and classroom (Halstead et al, 2013;McAvoy, Eagan-Johnson, & Halstead, 2018). To promote whole person care, health care professionals are encouraged to recommend specific AA when the student returns to school after concussion (Lumba-Brown et al, 2018;Rieger, Lewandowski, Potts, & Shea, 2019). Teachers are thereby tasked with integrating AA for a symptomatic student and noting improvements or declines throughout the student's recovery (McAvoy et al, 2018).…”