Palo Alto University BRAIN Lab Encourages Baseline Concussion Testing for Athletic Teens

“We could test entire teams at a school and coaches through our website and social media”

Every year, an estimated 3.8 million athletes suffer a concussion, and 70 percent of related ER visits are by children and teenagers. Rayna Hirst, Ph.D., associate professor of neuropsychology at Palo Alto University (PAU), isn’t surprised by these statistics. In her Behavioral Research and Assessment in Neuropsychology (BRAIN) Lab, where she is studying the effects of sports-related concussions, she says more than a third of the test subjects have had a mild traumatic brain injury. What she found astonishing is that parents of half of those kids did not seek medical attention, just the sort of behavior that Brain Injury Awareness Month, observed this month, aims to change. Hirst is passionate about educating the public about brain injuries and is available for interviews.

While Hirst’s study is in its early stages, with several papers published so far, Hirst and her team have uncovered some unexpected findings. Football gets most of the attention, but many youth athletes sustained concussions while involved in high-impact activities outside of organized sports, such as sailing, dirt biking and recreational basketball. Furthermore, when it comes to organized sports, athletes in positions where they are repeatedly tackled are at higher risk, while body mass index, age and the number of years of exposure were unrelated.

To recruit subjects for the study (which is temporarily on hold due to COVID-19 restrictions), Hirst offers free neuropsychological evaluation for athletes ages 8-16. Her team reviews each child’s medical history, interview the participant and a family member or caregiver, and administer a battery of tests that assess the youth’s memory, concentration, problem-solving skills and other cognitive functions. Parents get a detailed report of their child’s cognitive strengths and weaknesses. Athletes can be retested after a concussion, with the results compared to the baseline to help determine treatment and decisions about when a student can resume regular activity and return to the sport. Hirst also recommends retesting every year or two, also free “because kids develop cognitively at different rates.”

She says a healthy child may have abnormal scores on cognitive testing even on the baseline assessment, so she cautions parents not to read too much into one or two low scores. It’s also important to know those low baseline scores so they can be interpreted correctly in the event of an injury.

Hirst emphasizes the community service aspect of the concussion study. At the high school level, she says, many sports programs do basic baseline screening of athletes at the beginning of each season. However, middle schools and schools in lower socioeconomic regions don’t have the funds. That is where Hirst and her team can step in. By offering free testing, they are giving parents and school or league administrators access to a service they wouldn’t otherwise have. The study also offers information and resources for parents and coaches through their website and social media.

So far, the study’s database comprises about 130 youth, with longitudinal data on 30 of them, and Hirst would like to grow that number. Assessments are typically done in the lab, but “we can be mobile,” Hirst says. “We could test entire teams at a school and coaches through our website and social media”.

About Rayna Hirst, Ph.D.

Rayna Hirst is an associate professor and director of the Neuropsychology Program at Palo Alto University, providing didactic and supervisory education to doctoral students who are training in neuropsychology. Her research focuses on the validity and interpretation of neuropsychological assessment in a variety of clinical disorders. She also serves as the Research Director at San Francisco Neuropsychology PC, leading their clinical research program. She is a member of the National Academy of Neuropsychology Conflict of Interest Committee, the International Neuropsychological Society, and is Member-at-large and former Treasurer of the Northern California Neuropsychology Forum.

She completed her doctorate in Clinical Psychology, with a specialization in Neuropsychology, at the University at Albany, State University of New York. She completed her internship at the VA Ann Arbor/University of Michigan Healthcare System. Her postdoctoral fellowship was at the Dartmouth-Hitchcock Medical Center, in the Geisel School of Medicine. Her broad and diverse training has prepared her for the assessment of a variety of neurological and psychological disorders. In her clinical practice, she sees adults aged 18 and over (including older adults), for all types of neuropsychological evaluations, including ADHD, learning disorder, psychiatric disorders (e.g., depression, anxiety), medical diagnoses (e.g., multiple sclerosis, Parkinson’s disease, traumatic brain injury, neuro-oncology), and dementia.

Share article on social media or email:

Leave a Reply