Patterns of referral in high school concussion management programs: A pilot study of consultants from different disciplines

Jonathan D. Lichtenstein, Kate S. Linnea, Arthur C. Maerlender

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


School-based concussion management programs cover thousands of young athletes, yet there is little in the way of research to assess program processes or outcomes. This study examined the referral patterns of consultants working with ten high school concussion management programs. In addition to the number of referrals made to specialists, other potential outcome variables were explored. The sample included over 5,000 athlete-seasons and 298 concussions managed directly by certified athletic trainers. All programs used computerized neuropsychological testing (both baseline and post injury). Two groups were compared: five programs used a clinical neuropsychologist (NP) as the testing consultant and five used nonneuropsychologists (non-NP) with advanced clinical degrees as the testing consultant. There was no significant difference in concussion incidence rates between groups. Referrals to outside specialists were significantly higher for the non-NP group: X2(1) = 16.474, p <.0001. Further, concussions in the non-NP group took longer to recover overall (Mann-Whitney U, p =.013) and had significantly more cases taking longer than 2 weeks to complete their testing protocol: X2(1) = 9.672, p =.003. The findings of this pilot study support the idea that neuropsychologists are best suited for the role of testing consultant to high school concussion management programs.

Original languageEnglish (US)
Pages (from-to)334-341
Number of pages8
JournalApplied Neuropsychology: Child
Issue number4
StatePublished - Jun 28 2018


  • Computerized neuropsychological tests
  • Concussion management
  • Consultation
  • ImPACT
  • Sport-related concussion

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Developmental and Educational Psychology


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