Speaking English As A Second Language May Alter Results Of Sideline Concussion Testing

Athletes who speak English as a second language may have disparities when completing sideline concussion tests, according to research presented this week at the Association of Academic Physiatrists Annual Meeting in Sacramento, Calif.

From youth to professional sports teams, concussions are a concern for athletes who participate in football, soccer, rugby, and a number of other high-impact sports. Many of these sports are turning to sideline concussion testing to determine if a player should be removed from a game and further evaluated for a concussion.

One such sideline test is the King-Devick Test, which is a visual test that uses a series of cards and numbers to assess a player's ability to rapidly name numbers. The test is ideally initiated during a pre-season baseline and then it performed again on the sideline following a head impact.

If there is an increase in the time it takes to complete the task or an increase in errors, the player is removed from play and directed to a medical professional. Tests of this nature assist in reducing the likelihood of second impact syndrome, which occurs when a second concussion is sustained before a first concussion has fully and properly healed and has an associated mortality.

To determine if a difference in primary language can affect the results of sideline concussion testing, researchers from New York University Langone Medical Center and Icahn School of Medicine at Mount Sinai used the King-Devick Test to evaluate 27 native English speakers and 27 non-native English speakers.

"As with any patient evaluation, the ability of that individual to verbally express himself or herself in the language utilized for the evaluation should be taken into account," explains Lead Investigator, Joel Birkemeier, MD and Primary Investigator John-Ross Rizzo, MD, both from NYU Langone Medical Center, when commenting on addressing language barriers in testing.

The participants were predominately female with an age range of 24 to 52 years. Those who were non-native English speakers represented a number of primary languages with Spanish and Chinese being the most common. The participants were all healthy and had no history of concussion. Each participant completed a survey to determine how dominant they were in their primary language versus English as well as King-Devick test, which was administered in a controlled, non-sporting environment.