Management of Persistent Cognitive Symptoms After Sport-Related Concussion.

PURPOSE: This case review examines treatments speech-language pathologists at our clinic delivered to middle school, high school, and college students for the management of persistent cognitive symptoms after sport-related concussion. The goal is to examine a range of treatment options, describe clinical rationale for selecting those treatments, and report outcomes in order to identify feasible interventions for systematic evaluation through efficacy research.

METHOD: Review of clinic intake data identified 63 cases referred for cognitive rehabilitation over a 36-month period. Twenty-four cases (14 women and 10 men) met selection criteria, including documented sport-related concussion, postconcussion symptoms persisting at least 2 months with deleterious effect on school performance, and enrollment in secondary or postsecondary education. The authors independently coded demographics, treatment approaches, functional goal domains, and outcomes.

RESULTS: Treatment approaches fell into 4 broad categories: direct attention training, metacognitive strategy training, training assistive technology for cognition, and psychoeducational supports. Eighty-three percent of clients achieved self-selected functional goals.

CONCLUSIONS: Research has focused primarily on return to play and provision of academic accommodations in the initial weeks following concussion. Findings from this case series suggest that speech-language pathologists can deliver individualized interventions that lead to positive clinical outcomes. The authors hope findings encourage efficacy research.