Master of Arts, Miami University, 2021, Speech Pathology and Audiology

The percentage of concussions self-reported by collegiate athletes continues to be less than 50% despite the implementation of the National Collegiate Athletic Association's (NCAA) mandated concussion protocol. Unreported concussions leave affected athletes without beneficial medical, academic, and athletic intervention. This study's primary purpose was to identify factors positively and negatively influencing concussion reporting patterns in NCAA Division one (DI) athletes. A secondary purpose was to obtain the perspective of former collegiate athletes with a history of concussion on factors which may positively or negatively influence the culture of concussion reporting patterns in the future. Seven former NCAA DI athletes completed individual interviews to discuss their concussion experience in college including perceived support from various personnel, concussion education, and suggestions for changing the culture of concussion reporting. Athletic trainers (ATs) and parents were perceived to be supportive of concussion reporting, while participants relayed mixed feelings about coaches. All participants reported that the education received about concussion while in college was unmemorable and a majority expressed a lack of knowledge regarding symptoms of concussion. Suggestions for change included meetings dedicated solely to concussion education presented by a speaker with a personal history of concussion and increased use of visual educational materials.

Committee: Kelly Knollman-Porter Ph.D., CCC-SLP (Advisor); Renee Gottliebson Ph.D., CCC-SLP (Committee Member); Courtney Robinson M.S., CCC-SLP (Committee Member) Subjects: Health; Higher Education; Speech Therapy; Sports Medicine

Master of Arts, Miami University, 2017, Speech Pathology and Audiology

Introduction: Concussions affect various populations, including collegiate athletes and non-athletes. Yet, research examining knowledge of concussion within the collegiate population exclusively targets varsity athletics. The study's purpose was to obtain and compare collegiate varsity athletes, recreational athletes, and non-athletes' knowledge of concussion definition, symptoms, and support services available post-injury. Preferred methods of concussion education delivery was also examined. Method: Researchers surveyed 306 current college students using an online survey system. The survey included forced choice and free recall question formats. Quantitative and qualitative analyses were used to analyze results and compare responses among groups. Results: Collegiate athletes and non-athletes demonstrate incomplete knowledge of concussion definition, related symptoms, and professionals involved in concussion management. Varsity athletes rated self-knowledge of concussion parameters significantly higher than the other groups (p<.001), though few significant differences in actual knowledge levels were observed. Overall, respondents reported having the highest preference for concussion education delivered by medical professionals. Discussion: Knowledge concerning concussion is incomplete in the collegiate population. Varsity athletes' exposure to formal education did not result in higher knowledge levels compared to other groups. Further examination of concussion educational delivery models' effect on change in concussion-related behavior in this population is warranted.

Committee: Kelly Knollman-Porter Ph. D., CCC-SLP (Advisor); Renee Gottliebson Ph. D., CCC-SLP (Committee Member); Laura Kelly Ph. D., CCC-A (Committee Member) Subjects: Speech Therapy

MA, Kent State University, 2017, College of Arts and Sciences / Department of Psychological Sciences

Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is a widely used, computerized neuropsychological test battery for the diagnosis and management of sport-related concussions (SRC). As SRC is known to affect neurocognitive performance, athletes provide pre-injury, baseline ImPACT scores, to which post-injury scores can be compared in the event of SRC. However, if an athlete's baseline scores are not fully representative of his abilities, the utility of post-injury score comparison is diminished. Return-to-play release may be granted prematurely, putting the athlete at risk for second injury or long-term consequences. For this reason, the ImPACT includes low score thresholds on five validity indices to identify insufficient effort, though evidence of these indices' performance is limited. The present study compares existing ImPACT validity indices, as well as three proposed indices not currently being used to inform protocol validity, to external validity measures. The ImPACT, Word Memory Test (WMT) and Minnesota Multiphasic Personality Inventory – 2- Restructured Form (MMPI-2-RF) were administered to 242 undergraduate students. Participants were instructed to either give full effort on testing or to simulate SRC. The ImPACT demonstrated significantly higher specificity (0.94) and lower sensitivity (0.42) as compared to the WMT and MMPI-2-RF. Alternative score thresholds for the existing ImPACT validity indices may maintain high specificity while improving sensitivity. The three proposed indices showed higher sensitivities than the existing ImPACT indices, though lower specificities. The existing ImPACT indices' high specificity at the expense of lower sensitivity compared to external validity measures raises concern, as unidentified poor-effort may result in premature return-to-play decisions for athletes with SRC. Improvements or additions to the existing indices may raise sensitivity while maintaining acceptable specificity, aiding in the protect (open full item for complete abstract)

Committee: John Gunstad Ph.D. (Advisor); Mary Beth Spitznagel Ph.D. (Committee Member); Yossef Ben-Porath Ph.D. (Committee Member); John Updegraff Ph.D. (Committee Member) Subjects: Psychological Tests; Psychology

PHD, Kent State University, 2020, College of Arts and Sciences / Department of Psychological Sciences

The current study examined whether persons with a history of mTBI exhibited greater cognitive decline in response to physiological arousal than healthy controls. It was hypothesized that individuals with a recent history of mTBI would demonstrate poorer cognitive functioning at simulated high altitude than persons without such a history, and that sex and physical activity levels would moderate this relationship. Participants with a history of mTBI (n = 20) and never-injured controls (n = 28) completed two cognitive testing sessions using the NIH Toolbox Cognitive Battery: one at mean sea level, and one in a normobaric hypoxia chamber. Attention and executive functioning composite scores were created. Participants also completed questionnaires about their concussion history and affective change and altitude sickness symptoms. A mixed-model repeated measures MANOVA found a main effect of condition such that participants demonstrated improvements from sea level to simulated altitude (Wilk's Lambda = 0.23; F(2, 43) = 72.87, p < .001; ηp2 = 0.77) for both attention (F(1) = 109.34; p < 0.001; ηp2 = 0.71) and executive functioning (F(1) = 30.16; p < 0.001; ηp2 = 0.41) scores. There was also an effect of concussion history on cognitive test performance overall (Wilk's Lambda = 0.85; F(2, 43) = 3.94; p < 0.05; ηp2 = 0.16), though univariate analyses were nonsignificant when considering attention (F(1) = 1.71; p = 0.20; ηp2 = 0.04) and executive functioning (F(1) = 0.67; p = 0.42; ηp2 = 0.02) independently. Univariate interactions were observed between condition and gender on the attention composite score (F(1) = 4.51; p < 0.05; ηp2 = 0.09), such that males exhibited greater improvement from sea level to simulated altitude than did females, and among condition, group, and gender on executive functioning (F(1) = 4.58; p < 0.05; ηp2 = 0.09), such that female participants with a history of concussion experienced the least improvement from sea level to simulated altitude. Ex (open full item for complete abstract)

Committee: John Gunstad Ph.D. (Advisor); Mary Beth Spitznagel Ph.D. (Committee Member); John Updegraff Ph.D. (Committee Member); Ellen Glickman Ph.D. (Committee Member); Ernest Freeman Ph.D. (Committee Member) Subjects: Psychology

Master of Science, Miami University, 2017, Exercise and Health Studies

This study presents the results of a phenomenological qualitative analysis of former team sport athletes' experiences of physical and psychological effects of sport-related concussion. Concussions have become increasingly prevalent in sport and knowledge surrounding the injury has become more available. Most research on sport-related concussions has focused on return to play and the physiological aspects of the injury; however, concussed individuals may also suffer psychological symptoms. Former athletes are experiencing health issues due to the physical and psychological nature of this injury. This study sought to add to this literature by exploring what physical and psychological effects former high school/collegiate team sport athletes experienced because of a sport-related concussion and the meanings they make of (how they experienced) these physical and psychological effects of a sport-related concussion.

Committee: Valeria Freysinger (Advisor); Robert Weinberg (Committee Member); Eric Brooks (Committee Member) Subjects: Health Sciences; Kinesiology; Psychology; Social Psychology; Sports Medicine

Specialist in Education (Ed.S.), University of Dayton, 2017, School Psychology

This study utilized a mixed-methods design to evaluate the effectiveness of online concussion training programs at increasing school professionals' concussion awareness, knowledge and confidence in concussion identification and response and their ability to apply skills in relation to concussion recognition and response. Participants (n = 30) in the Teacher Training and (n=11) in the Team Training completed the training online and had access to the training manual and resources online. Prior and gained knowledge were measured through pre- and post- tests. Results indicated that both the Teacher and Team online trainings yielded significant results in increasing confidence in concussion identification and response, as well as knowledge and awareness of concussion. The Teacher Training also indicated significant results in relation to increased skills application. Additionally, a content analysis of pre- to post- test responses on qualitative questions showed an increase in word count, depth in response, and use of training terminology in response to skills application questions on the Teacher Training, and participant role in concussion response teams on the Team Training. Limitations and implications for future use of online concussion training programs for teachers and other school staff are discussed.

Committee: Susan Davies Ed.D. (Committee Chair); Elana Bernstein Ph.D. (Committee Member); Joni Baldwin Ed.D. (Committee Member) Subjects: Early Childhood Education; Education; Educational Evaluation; Educational Psychology; Health Education; Health Sciences; Public Health Education; Teacher Education

MS, University of Cincinnati, 2012, Medicine: Clinical and Translational Research

Background: A cluster of cognitive, physical, emotional / behavioral and sleep problems referred to as post-concussion syndrome (PCS) occurs following mild traumatic brain injury (mild TBI) in a subset of children. Limited evidence suggests that patient and injury characteristics contribute to the development of PCS. Objective: To determine the acute predictors associated with the development of PCS in children. Methods: Retrospective analysis of a prospective observational study of children ages 5 to 18 years presenting to the Emergency Department (ED) with mild TBI. All patients had data related to the injury recorded during the initial ED visit. Telephone follow-up administration of the Rivermead Postconcussion Questionnaire was conducted at three months post injury. In a convenience sample, serum was analyzed for the biomarker S100B. Univariable and multivariable logistic regressions were performed. Results: 29% of children presenting to the ED with mild TBI developed had PCS. The most frequent PCS symptom was headache. Predictors of the development of PCS were age, headache on presentation in the ED and admission to the hospital, while controlling for other covariates. S100B levels alone did not predict development of PCS. Children who developed PCS missed, on average, 7.4 (SD 4.9) days of school. Conclusions: Children, who were older, had headache on ED presentation and required hospital admission at ED encounter, were at high risk of PCS following TBI. Interventions to identify and begin early treatment for this population may be of benefit to improve outcomes and reduce burden of disease.

Committee: Erin Nicole Haynes PhD (Committee Chair); Shari Wade PhD (Committee Member); Paul Succop PhD (Committee Member) Subjects: Surgery

Master of Arts, Miami University, 2007, Speech Pathology and Audiology

Research has shown possible risk factors associated with a greater incidence of sports-related concussion and varying recovery patterns. This study examined athletic positions, gender, and previous history of concussion to investigate the risk factors of sustaining a concussion and of affecting an athlete's recovery. Results are as follows: football players in offensive positions have a greater risk for sustaining a concussion than those in defensive positions; there is no difference in the severity of the concussions or in the rate of recovery between offensive and defensive football players; athletes in non-contact sports are more at risk for a concussion than those who participate in contact sports; each concussion an athlete sustains increases the risk of sustaining a future concussion by 50%; if an athlete has sustained three or more prior concussions, it is probable that more symptoms will accompany each subsequent concussion; male athletes have more symptoms than female athletes.

Committee: Fofi Constantinidou (Advisor) Subjects: Speech Communication

Specialist in Education (Ed.S.), University of Dayton, 2013, School Psychology

This study examined the efficacy of school-based training paired with ongoing consultation and continued dissemination of information to improve educator's knowledge and response related to concussions, through a quasi-experimental design. The experimental group (N = 14) received ongoing consultation and continued dissemination of concussion resources via email for four months following the training; the control group (N = 6) received the training but no further consultation or dissemination of information. It was hypothesized that the experimental group would be more likely to retain the knowledge and improve services with students who sustained concussions. This was measured through a Pre-Training Questionnaire, Post-Training Questionnaire, and four month Follow-Up Questionnaire. While there was no statistically significant difference between the two groups; there was a main effect for training with both groups demonstrating an increase in concussion knowledge, recognition, and response across three time periods. Furthermore, 15 students were provided accommodations after sustaining a concussion by participants in the experimental group, whereas one student was provided accommodations after sustaining a concussion in the control group. In addition, the school psychologist in the experimental group consulted on 17 concussion cases, whereas the school psychologist in the control group consulted on zero concussion cases.

Committee: Susan Davies Ed.D. (Committee Chair); Elana Bernstein Ph.D. (Committee Member); Joni Baldwin Ed.D. (Committee Member) Subjects: Education; Educational Psychology; School Administration; School Counseling; Secondary Education

Specialist in Education (Ed.S.), University of Dayton, 2024, School Psychology

The current study examined the experiences of young adults who sustained concussions, with regard to their encounters with interdisciplinary treatment approaches and the subsequent impact on their recovery process. Young adults often pursue post-secondary education, working, or both, and return to learn/work protocols are often not well managed or non-existent for individuals with concussions. There is also a general lack of understanding as to how a concussion may manifest in the young adult's life, both with short-term and long-term difficulties. Using a mixed method research design, the effectiveness of interdisciplinary concussion treatment methods on participant quality of life was investigated by measuring quality of life before and after injury using the Quality of Life After Brain Injury (QOLIBRI) questionnaire. Paired samples t-tests were conducted to analyze mean differences in six quality of life domain scores pre- and post-interdisciplinary treatment. Findings suggest that quality of life for young adult participants statistically significantly increased in the areas of cognition and daily functioning and independence, while other areas (view of self, social relationships, physical problems, and current feelings) were not statistically different post-treatment. Qualitative analysis of individual interviews with young adults who have undergone such treatments identified several broad themes related to challenges and successes in their recovery journeys. When identifying challenges, themes included a decline in functioning after injury, delays in or lack of care, and feeling the need to push through difficulties. When identifying facilitators, themes included receiving helpful interdisciplinary treatment strategies, feeling empowered by recovery progress, and receiving support from family, friends, and professionals. Implications regarding the findings and continued concussion research are discussed.

Committee: Susan Davies (Committee Chair); Rachelle Janning (Committee Member); Elana Bernstein (Committee Member) Subjects: Educational Psychology; Health Care

PhD, University of Cincinnati, 2024, Medicine: Neuroscience/Medical Science Scholars Interdisciplinary

Sports-related brain injuries, including both sports-related concussions (SRCs) and repetitive head impacts (RHI), are forms of brain injury that result from a direct hit to the head or biomechanical forces that are transmitted from the body to the head. It is estimated that 1.6 to 3.8 million SRCs occur annually with approximately 1.9 million occurring annually in adolescent athletes. With previous research focused on the management of neurocognitive and neurobehavioral symptoms following SRC, neuromuscular control deficits are also present in athletes following concussion. Neuromuscular control alterations have been noted up to two years following initial injury, potentially placing athletes at an increased risk for lower extremity injury following clearance of return to play. Additionally, athletes with a prior history of SRC have demonstrated a ~2.5 times greater risk for subsequent lower extremity injury compared to uninjured controls. Behavioral data has provided initial insight into the relationship between SRC and lower extremity injury, however, changes in the central nervous system (CNS) underlying this relationship have not been fully realized. Characterizing neural alterations associated with motor control may provide further insight as to why athletes with a history of SRC display neuromuscular deficits. Additionally, there is an unclear understanding of how RHI exposure may precipitate to the development of motor control deficits. Unlike athletes with an SRC, the absence of overt clinical symptoms, behavioral changes, or neurocognitive manifestations may lead to this population being overlooked. To characterize how sports-related brain injuries may lead to motor control deficits, a literature review is warranted to present the current evidence as it relates to sport-related head injuries, and subsequent lower extremity injury. The literature synthesis (Chapter 1) will provide a comprehensive overview of SRC, RHIs, and previous work that has identified (open full item for complete abstract)

Committee: Mark Baccei Ph.D. (Committee Chair); Jed Diekfuss Ph.D. (Committee Member); Michael Riley Ph.D. (Committee Member); Gregory Myer (Committee Member); Weihong Yuan Ph.D. (Committee Member); Russell Gore M.D. (Committee Member) Subjects: Neurosciences

PhD, University of Cincinnati, 2023, Arts and Sciences: Psychology

Background: It is estimated that at least 225,000 children are seen in Emergency Departments (ED) for concussion in the United States each year. Studies have shown that positive coping skills and psychological resilience influence post-concussive symptoms. No work in this limited field has examined the influence of coping skills and psychological resilience in the same study sample. Additional research is warranted to investigate the relationship between these factors and concussion outcomes during the acute recovery period to determine the most appropriate targets for therapy and who may be most likely to benefit. I hypothesized that the problem-focused engagement coping style (PFE) would mediate post-concussive symptoms at both two- and four-weeks post-injury and that pre-injury psychological resilience would moderate concussion symptoms at these timepoints. In addition, I hypothesized a moderated mediation model, such that the influence of PFE would be more evident in individuals with higher levels of pre-injury resilience. Method: 61 adolescents (ages 11-18) who sustained a concussion completed measures of coping (Coping Strategies Inventory-Short Form), and concussion symptoms (Health and Behavior Inventory) beginning in the emergency department and weekly throughout the four-week course of an online intervention study. Resilience (Connor-Davidson Resilience Scale), was measured only in the ED. Multiple imputation with predictive mean matching was utilized to account for missing data. Analyses included the Baron and Kenny procedure for estimating mediation effects and Hierarchical Bayesian methods were used to test any potential mediation effects in both the overall sample and following a mean split to investigate moderated mediation. Multiple regression analyses were used to evaluate moderation effects. Results: Coping and resilience were significantly correlated with concussion symptoms at both timepoints (r(60) ranged from -.37 to -.28 for coping skil (open full item for complete abstract)

Committee: Shari Wade Ph.D. (Committee Chair); Paula Shear Ph.D. (Committee Member); Jeffery Epstein Ph.D. (Committee Member) Subjects: Psychology

Specialist in Education (Ed.S.), University of Dayton, 2023, School Psychology

Traumatic Brain Injuries (TBI) can have a devastating impact on victims and their families. Families living in rural communities experience unique barriers to receiving care for complex medical needs. While little research exists surrounding TBI specifically, medical staff, school staff, and caregivers for children with complex medical conditions report a range of barriers and facilitators to coordinating care for their child. The current study explored the experiences of rural caregivers for children with TBI, gaining the insights of caregivers, school staff, and medical professionals who cared for a child with a TBI who transitioned to public school after the injury. Themes included the need to navigate complex situations, support from small communities, isolation and loneliness, differences in experience based on severity of injury, and feelings of hope. Barriers to quality care coordination included navigating complex situations, access to transportation, and lack of communication or education from agencies. Facilitators included support from small communities and interagency communication. Based on information from the interviews, more comprehensive coordination between agencies is recommended, including care coordination that was not limited to that covered by insurance. Implications for practitioners include being cognizant of the difficulties caregivers face, providing flexibility due to transportation barriers, creating more comprehensive care for students with mild TBI, and providing more education.

Committee: Susan Davies (Committee Chair) Subjects: Developmental Psychology; Early Childhood Education; Education Policy; Educational Psychology; Families and Family Life; Health Care; Health Care Management; Physical Therapy; Psychology; School Administration; School Counseling; Special Education; Sports Medicine

Master of Science, The Ohio State University, 2022, Vision Science

Sports-related concussions in pediatrics and adolescents can be asymptomatic and often go undiagnosed. Pupil testing strategies may be used as a potential objective screening tool for concussion. The purpose of this work was to perform longitudinal assessments of pupil responses to pulses of red and blue light in youth hockey players to assess the function of the neural circuitry mediating the pupillary light reflex, while also determining the repeatability of these responses. In addition, assessments of cognitive function and surveys of symptoms were performed to determine the repeatability of these concussion screening tools across the hockey season. There were 18 males, each 13 years old, enrolled in the cohort study at the start of the youth hockey season. Pupil responses to flashes of alternating red and blue light, applied at 0.1 Hz for 2 min, were recorded using the RAPDx pupillometer (Konan Medical). The data was collected in three sessions, each separated by approximately two months, conducted at the start, middle and end of the hockey season. Average pupil constriction during the first red versus first blue pulses, and the difference in constriction between the first and last pulses of red light were calculated. Symptoms were quantified with the Convergence Insufficiency Symptoms Survey (CISS) and Rivermead Post-Concussion Symptoms Questionnaire (RPCSQ). Cognitive function was measured using CogState Brief Battery Assessment. The average difference between the pupil responses to the first red and the first blue flash, a marker of the contribution of melanopsin-driven responses to pupil constriction, was significantly correlated (R = 0.61; P < 0.001) with the change in pupil constriction that occurred across the pupil test, termed photopotentiation (measured as the difference in pupil responses to the first and last red flashes). Bland-Altman analyses demonstrated that there was not a significant difference in the pupil responses to the first red and (open full item for complete abstract)

Committee: Andrew Hartwick OD, PhD (Advisor); Phillip Yuhas OD, PhD (Committee Member); Catherine McDaniel OD, MS (Committee Member) Subjects: Neurosciences; Ophthalmology; Optics

Psy. D., Antioch University, 2021, Antioch New England: Clinical Psychology

This dissertation explored the relationship between head injury and violent crime among professional football players. This study was particularly focused on determining if the frequency or severity of head injury was related to the severity of violent crime among National Football League (NFL) football players. Additionally, this study explored possible differences in violence severity and concussion history among offensive and defensive positions. Based on information gathered from publicly available archival databases, sixty-three participants were placed into four groups based on their concussion and violent crime histories. Pearson correlations were conducted to determine the relationship between concussion history and violent crime severity. Independent Sample t-Tests were also completed to determine any significant difference in violence severity among participants with and without concussion history; as well as to determine any significant difference in concussion history among participants with and without a violent criminal history. Chi-square analyses were conducted to examine the relationship between National Football League (NFL) position and concussion history, as well as history of violence. An ANOVA was used to compare career lengths of the participants in the four study groups. Results suggest no significant relationship between concussion severity or concussion frequency and the severity of violent crime in participants. Participants with a concussion history but no violent criminal history had significantly longer NFL careers compared to participants in each of the other groups. Although a relationship was not identified in this study, further investigation into the negative outcomes of repetitive head injuries remains crucial. Limitations of the present study are discussed, and recommendations are made for future research.

Committee: Kathi Borden PhD (Committee Chair); Susan Hawes PhD (Committee Member); Theodore Austin PsyD (Committee Member) Subjects: Clinical Psychology

Specialist in Education (Ed.S.), University of Dayton, 2021, School Psychology

Objective: To examine the efficacy of an online traumatic brain injury (TBI) professional development intervention for preservice educators, In the Classroom After Concussion: Best Practices for Student Success. Design: A random total sample of 55 preservice educators, with 34 in the test group, and 21 in the control group. Test participants completed the pretest, nine online training modules, and the posttest. The control group completed only the pretest and posttest. Results: On the posttest assessment, in comparing the difference in scores from pretest to posttest, test group participants showed significantly greater gains in knowledge (M = 4.65, SD = 6.08) than the control group (M = .19, SD = 5.34). Conclusion: Given the increasing prevalence of TBI in school-aged children, it is paramount to develop and provide cost effect, evidence-based, and easily accessible trainings for TBI professional development. The In the Classroom trainings can be one solution. Implications for effective training will be discussed.

Committee: Susan Davies Ed.D (Committee Chair); Elana Bernstein Ph.D (Committee Member); Joni Baldwin Ed.D (Committee Member) Subjects: Counseling Education; Mental Health; Special Education

Master of Arts in Psychology, Cleveland State University, 2021, College of Sciences and Health Professions

In the field of neuropsychology, feigning symptoms, also known as malingering or response bias, is an important issue as a large number of assessment referrals are for individuals that may receive benefits if the assessment results suggest cognitive impairment. Therefore, it is crucial to have valid and reliable measures that detect the feigning of symptoms (Slick et al., 1999). Currently, the tests that are routinely used to detect response bias are vulnerable to coaching. The goal of this study was to validate a new response bias test aimed at being less susceptible to coaching than existing measures: The Tri-Choice Naming and Response Bias Measure (N-Tri). To this end, 400 participants were assigned to either the coached malingerers' group, uncoached malingerers' group, or control group. Participants completed an online survey consisting of the N-Tri, Reliable Digit Span (RDS), and Portland Digit Recognition Test (PDRT). ROC curves demonstrated that all three tests were able to detect coached malingerers from controls, but the N-Tri had higher sensitivity than the RDS and PDRT. Thus, the N-Tri was able to better detect coached malingerers than compared to the RDS and PDRT. Several additional hypotheses were examined.

Committee: Amir Poreh (Committee Chair); Elizabeth Goncy (Committee Member); Colleen McMahon (Committee Member) Subjects: Clinical Psychology; Neurosciences; Psychological Tests; Psychology

Specialist in Education (Ed.S.), University of Dayton, 2020, School Psychology

Previous research related to concussion knowledge and attitudes has focused mostly on adult athletes. There is a gap in research examining concussion knowledge and attitudes in youth. Concussions that occur in youth can have enduring effects, especially if more than one concussion occurs before the brain has had a chance to fully heal. Higher levels of concussion knowledge can lead to better responses and behaviors should a concussion occur, potentially limiting the long-term effects. Therefore, the purpose of this study was to examine levels of concussion knowledge and attitudes towards concussions in youth athletes who participate in high risk and low risk sports. Participants were ages 9-14 selected from a suburban elementary and middle school. Risk by sport was identified and categorized based on existing research. Participants completed a modified version of the Rosenbaum Concussion Knowledge and Attitudes Survey-Student Version (ROCKAS-ST) survey containing questions related to fact-based concussion knowledge and behavior-based concussion attitudes. Surveys were examined and scored with each participant receiving and knowledge index score and attitudes index scores. Results indicated concussion knowledge was lacking among participants; however, overall attitudes were in the acceptable range. There was no significant difference in the amount of concussion knowledge or attitudes between athletes in high risk versus low risk sports. Additionally, older participants (ages 13-14) had more appropriate attitudes towards concussions than the other participants (9-12), indicating they would demonstrate appropriate behaviors if they ever sustained a concussion, but there was no difference in the level of knowledge between the various age groups. Results of this study addresses the gap in research examining concussion knowledge in youth of different ages and in different types of sports. While participants had some knowledge, more is likely needed to ensure appropriate b (open full item for complete abstract)

Committee: Susan Davies (Committee Chair); Elana Bernstein (Committee Member); Corinne Daprano (Committee Member) Subjects: Education; Psychology

MA, University of Cincinnati, 2020, Arts and Sciences: Psychology

Though research highlights the importance of examining ADHD and repetitive head impacts as they relate to concussion symptoms, historically these variables have been assessed independently of one another. However, there is increasing evidence that ADHD and head impacts should be examined in conjunction. We hypothesized that increased repetitive head impact exposure over the course of an athletic season would result in increased post-season concussion symptoms, and that increased ADHD symptom severity would strengthen this association. Study participants included 447 athletes aged 13-19 years old who participated on a high school boys' football or girls' soccer team (football = 276, soccer = 171) over the course of a single athletic season. ADHD symptoms were assessed at pre-season using parent-reported Strengths and Weaknesses of ADHD Symptoms and Normal Behavior (SWAN) ratings. Concussion symptoms were assessed using athlete- and parent-reported ratings on a modified Post Concussion Symptom Inventory (PCSI) at pre- and post-season. Head impacts were measured using an accelerometer worn behind the left ear by athletes during all head impact exposure (practices and games). Mixed-model analyses were used to examine the moderating effects of ADHD symptom severity on the association between repetitive head impacts (>90g) and post-season PCSI symptom ratings, controlling for pre-season PCSI ratings. In football and soccer players, neither repetitive head impacts, nor ADHD symptoms, were associated with increased post-season athlete- or parent-reported PCSI ratings, with the exception that increased ADHD inattentive symptoms were associated with increased parent-reported PCSI Cognitive factor scores at post-season. ADHD symptoms did not moderate associations between repetitive head impacts and any post-season PCSI factor score. These results indicate that broadly, ADHD symptoms do not appear to exacerbate the effects of repetitive head impacts after a single seas (open full item for complete abstract)

Committee: Jeffery Epstein Ph.D. (Committee Chair); Quintino Mano Ph.D. (Committee Member); Shari Wade Ph.D. (Committee Member) Subjects: Psychology

Doctor of Philosophy, Case Western Reserve University, 2020, Communication Sciences

Purpose: The identification and management of pediatric concussion is a public health concern and research in this area is rapidly evolving. While the literature has identified cognitive deficits that often occur in the acute concussion recovery period, cognitive- communication deficits associated with high-school youth concussion are less well identified. The overall aim of this dissertation was to create a cognitive-communication profile for high-school aged youth within 30 days post-concussion and to identify the impact of age and number of concussions on assessment performance. Method: This cross-sectional design included 20 participants (11 males and 9 females), who ranged from 14-17 years of age (M=16;0). Participants completed a 2-hour assessment battery, consisting of the Comprehensive Assessment of Spoken Language (CASL-2), Behavior Rating Inventory of Executive Function-Self Report (BRIEF-2), Parent-Reported Outcomes Measurement System (PROMIS) Pediatric Cognitive Function and Pediatric Peer Relationships, and the Standardized Assessment of Concussion (SAC) of the Sport Concussion Assessment Tool (SCAT-5). Parents of participants completed the BRIEF-Parent Report, PROMIS Cognitive Function, and PROMIS Peer Relationships. Results: Participants scored in clinically significant range on the SAC of the SCAT-5 including: delayed recall (59% accuracy), immediate recall (64.8% accuracy), concentration (68% accuracy), and total score (66.5% accuracy). No clinically significant areas were identified on the CASL-2, BRIEF-Self Report, BRIEF-Parent Report, or the PROMIS measures; however, subtests with discrepant performance were found in pragmatic language, grammaticality judgement, and syntactic index score on the CASL-2 and working memory on the BRIEF-Self. Age and number of concussions significantly contributed to the models of pragmatics (p=<0.05), delayed recall (p=0.004), immediate recall (p=0.033), and concentration (p=0.02). Coefficient analysis revealed sig (open full item for complete abstract)

Committee: Angela Ciccia (Committee Chair) Subjects: Communication; Speech Therapy