Dr. Karen Liller examines concussions among children

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For more than a decade USF College of Public Health’s Dr. Karen Liller, professor in the Department of Community and Family Health, has studied sports injuries and concussions among adolescents.

However, she said there was little to no data on very young children playing in recreational sports leagues outside of a formal school setting.

She and her research colleague Dr. Barbara Morris decided to change that.

(Photo courtesy of Pixabay)

“As reported by the CDC, concussions can result in many symptoms, such as headaches, nausea, difficulty thinking clearly, and sleeping more than usual,” Liller said. “Multiple concussions can lead to chronic traumatic encephalopathy (CTE), a degenerative brain disease found in some NFL players.”

According to Liller, the CDC reports that most people with a concussion recover well, however, for some, symptoms can last for days, weeks or even longer.

“Recovery may be slower among certain age groups, including young children” she said. “We still are studying the role of concussions in children to determine any and all long-term effects.”

Their research, “Analysis of Baseline Computerized Neurocognitive Testing Results among 5–11-Year-Old Male and Female Children Playing Sports in Recreational Leagues in Florida,” published in the International Journal of Environmental Research and Public Health, is the first to collect baseline concussion data in real time on this age group within this setting.

Dr. Karen Liller (Photo by Caitlin Keough)

Using computerized neurocognitive testing (CNT), Liller and colleagues collected data among children ages 5 to 11 via one particular test called ImPACT Pediatric.

CNT is done for baseline and follow-up concussions among athletes, Liller said, and can be administered by certified athletic trainers who are typically the first providers identifying and evaluating injured players.

ImPACT Pediatric is a tablet-based test that does not depend on reading skills and was specifically designed for 5 to 11-year-old children, according to Liller. It is also the only FDA-cleared assessment tool for this age group.

“This is testing done for baseline and follow-up concussions that assesses cognitive status by specific neurologic domains such as memory, attention, processing speed, etc.,” Liller said. “While other CNT tools have been used in older children and adults, the very young athletes represent a challenge due to maturity levels and comprehension. ImPACT Pediatric has been designed to address these issues.”

657 baseline tests were conducted from 2016 to 2017 among both male and female children ages 5 to 11 playing football, girls and boys soccer, softball, and baseball in Hillsborough County, Fla.

“We were very excited about the findings in that we showed that ImPACT Pediatric could be successfully administered by certified athletic trainers with young children in recreational settings,” Liller said. “We also have the earliest research showing differences in baseline findings among girls compared to boys in terms of visual memory.”

(Photo courtesy of Pixabay)

Results indicated that females scored better on visual memory and as age increased, so did baseline scores in both males and females for most of the indicators.

“We are still studying why young female children did better on visual memory than young male children,” Liller said. “Studies on older college athletes showed the reverse, however, those researchers were not using ImPACT Pediatric.”

ImPACT Pediatric scores are important, according to Liller, because they can then be compared to post-concussion findings to add to the information medical personnel have in treating the athlete.

“Future research will allow us to continue to use the tool with more diverse young populations throughout Florida and beyond,” she said. “The findings will help us understand the role of these tools in learning more about concussions in young populations. From this information, interventions may be developed to enhance the health of the athlete.”

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Liller, K., Morris, B., Fillion, J., Yang, Y., & Bubu, O. (2017). Analysis of Baseline Computerized NeurocognitiveTesting Results among 5–11-Year-Old Male and Female Children Playing Sports in Recreational Leagues in Florida. International Journal of Environmental Research and Public Health, 14: 2-7.

 

Story by Anna Mayor, USF College of Public Health

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