Sideline Tests For Concussion May Be Less Accurate For Non-Native English Speakers

King-Devick

An example of the King-Devick Test, used to diagnose concussions on the sidelines of sporting events.

New research presented this week at the Association of Academic Physiatrists Annual Meeting in Sacramento, California, suggests current sideline concussion assessments may not properly take primary language into consideration, which may be leading to disparities in concussion diagnosis rates.

Many athletic teams from pee-wee football to the pros are turning to sideline tests to provide fast diagnoses to athletes who may have experienced a brain injury during game, but their accuracy is still questioned by man experts.

One popular test is the King-Devick Test, a visual test using a series of cards with numbers. Athletes are asked to rapidly name numbers, and their results are compared to a baseline assessment to potentially identify any deficits that may indicate the player experienced a brain injury.

The idea is that if there is an increase in the amount of time or number of errors when completing the task, the athlete is removed from play until they can be further assessed. This lessens the chance of further, more serious injury occurring.

Researchers from New York University Langone Medical Center and Icahn School of Medicine at Mount Sinai suspected language may be influencing the accuracy of the test. To determine if an athlete’s primary language might influence the results of these types of sideline concussion test, the researchers recruited 54 healthy participants with no history of concussion. Half of the group spoke English as their primary language, while the other 27 were non-native English speakers with Spanish and Chinese being the most common primary languages.

Each participant underwent the King-Devick test in a controlled, non-sporting environment, as well as completing a survey to determine how dominant they were in their primary language compared to English. The results showed the tests were less accurate on those who spoke primary languages other than English.

“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.

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