Concussion Management Program
The Athletic Arena as Neuropsychology Laboratory
In all contact sports there is a risk of concussion, which provides a unique opportunity to examine individuals both before and after a suspected brain injury takes place. Florida Tech employs a comprehensive Concussion Management Program (CMP) to 1) educate student-athletes and coaches in identifying concussion symptoms toward promoting safety, 2) accurately diagnose concussions using standardized, evidence-based protocols, and 3) provide recommendations and/or accommodations for concussed students to facilitate their recovery while minimizing the impact of their injury on their academic performance. There are several components of a successful CMP, providing multiple training opportunities for clinical psychology students with a neuropsychology interest.
The CMP begins in the preseason when all student-athletes undergo testing to determine their normal (baseline) performance on various tests of cognition, balance, and coordination, and to establish the degree to which they typically experience a variety of symptoms. Clinical psychology students conduct these baseline assessments and mental health screenings, and also provide basic concussion education to student-athletes. If a student-athlete later suffers a head trauma during participation in sports, and/or complains of symptoms that are highly suggestive of concussion, the athlete is immediately withheld from further participation in sport-related activities and will evaluated as quickly as possible by a Certified Athletic Trainer (ATC). Typically, within 24 - 48 hours of the incident, the Concussion Management Team of the School of Psychology will then assess the student-athlete’s cognitive and balance abilities, as well as document any symptoms being experienced. The post-trauma performance will be compared to the baseline performance obtained during the preseason assessment. If post-trauma performance is determined to be notably different in comparison to the student-athlete’s baseline, it may be concluded that a concussion has occurred. Student-athletes diagnosed with a concussion may not engage in team activities until the sports medicine team determines that they have recovered and returned to their baseline performance levels.
The average time to recover from a mild concussion is typically 7-10 days; however, some individuals may require several weeks or more to recover fully. When a student-athlete reports being symptom-free to the athletic trainer, a referral back to the Concussion Management Team will be initiated so that a follow up evaluation can be performed. Clinical psychology students receive training in conducting these clinical interviews and performing brief neurocognitive and balance assessments with student-athletes suspected of having a concussion. During clinical interviews, particular attention is devoted toward collecting a detailed clinical history and information pertinent to the unique aspects of this type of neurological injury, including specifics regarding the mechanism of injury and symptoms experienced at the time and thereafter. If it appears that a concussion has occurred, recommendations are made potentially including behavioral strategies to assist with symptom management and academic accommodations.
Once student-athletes’ symptoms have resolved and their neurocognitive, balance, and coordination abilities are determined to have returned to normal by the Concussion Management Team, the athletic trainer will administer a physical exertion test to ensure that intense physical exercise does not result in a return of post-concussive symptoms. If all appears normal, the team physician will return the student-athlete to all sport-related activities. During the course of concussion recovery, it is not uncommon for physical symptoms to be reduced or absent, while lingering neurocognitive impairments remain. This is why accurate interpretation of neurocognitive testing is always critical prior to the decision to return the student-athlete to full athletic activity. Our goal is to ensure that our student-athletes suffer no preventable harm from playing their sport, and that they are not asked to perform on the field or in the classroom when they are vulnerable or cognitively unable to give their best. Through this experience, clinical psychology students receive training on the most updated and state-of-the-art methods of concussion diagnosis and management.
Research and Clinical Activities for Florida Tech Students
Concussion research and clinical supervision is led by Anthony LoGalbo, Ph.D., ABPP-CN, who is a core clinical faculty member of the Florida Tech Psy.D. Program, and a board-certified clinical neuropsychologist with nearly 15 years of sports concussion experience at the high school, college, and professional level. Dr. Frank Webbe, Professor Emeritus, directed Florida Tech’s CMP for several years and has been an integral contributor to the field of sports neuropsychology and concussion research. The student members of the Concussion Management Team also use data from assessments of our student-athletes and others to fuel new evaluation methods and treatment approaches. There are opportunities for partial funding as a Graduate Tuition Scholar (for first year students) and/or Graduate Student Assistantships (for subsequent years) as well. Clinical Psychology doctoral students who desire to become involved in this program and gain experience in the assessment and treatment of concussion, as well as the attendant research, are welcome to contact Andrew DaCosta for additional information.
Members of the Concussion Management Team can expect to learn and gain experience in conducting specifically oriented clinical interviews and administering common neurocognitive assessments including the Sport Concussion Assessment Tool, 5th Edition (SCAT5) and the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), as well as balance and coordination tests (e.g., the Balance Error Scoring System, or BESS), and external tests of effort and assessment validity. The team conducts baseline testing of all student athletes in preseason (typically mid-August), and evaluates athletes for possible concussions throughout the school year depending on the sport season. Experience in delivering concussion educational sessions can also be obtained. Team members must have sufficient availability to conduct trauma tests at short notice and perhaps at irregular times (e.g., evenings, weekends) since this is an on-demand activity. Clinical students may count the educational activities, baseline testing, and trauma testing in their “Time-to-Track” folder. Participating in the CMP allows for a unique and exciting opportunity to interact with student-athletes and sports medicine staff, while learning to conduct and interpret relatively brief neuropsychological assessments toward making a clinical diagnosis, writing concise clinical reports, and providing recommendations to facilitate student-athletes’ recovery. Involvement in these clinical activities allows interested students to become involved in many ongoing applied concussion research projects as well. Some examples of recent research projects are highlighted below.
Recently Published Research:
LoGalbo A., DaCosta, A., Webbe, F.M. (2020). Comparison of the PHQ9 and ImPACT Symptom
Cluster Scores in Measuring Depression Among College Athletes. Applied Neuropsychology: Adult, https://doi.org/10.1080/23279095.2020.1805611
DaCosta, A., Webbe, F.M., LoGalbo, A. (2020). The Rey Dot Counting Test as a Tool for Detecting
Suboptimal Performance in Athlete Baseline Testing. Archives of Clinical Neuropsychology, acaa052, https://doi.org/10.1093/arclin/acaa052
DaCosta, A., Crane, A., Webbe, F., & LoGalbo, A. (2020). Change in Balance Performance Predicts
Neurocognitive Dysfunction and Symptom Endorsement in Concussed College Athletes. Archives of Clinical Neuropsychology, acaa031, https://doi.org/10.1093/arclin/acaa031