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New Tech to test students

Hey all!

I use ImPACT and I just heard that now it is possible to use chromebooks to test kids. Have you heard or tried it already?
What do you use in class to test your students? How do you create tests that are simple and doesn't cost an arm and a leg?

Are you more in favor of paper copies or 1:1 program?


  • Neurocognitive testing has become a huge industry. Like anything else, there are pros and cons. Although it is meant to be a tool, too many professionals are using it as THE tool – an “end-all-be-all”. It is not just athletic trainers who possess this mentality. Practicing physicians are telling parents that if a school is not using ImPACT then they are “behind the times”.

    I have never and will never use ImPACT testing. First and foremost, research has shown that athletes need complete rest after a TBI. Complete rest includes physical and mental aspects. If we as ATs are telling our athletes that they are not allowed to text, watch tv, run around, etc., what message are we sending them when we sit them down in front of a computer to take a test? Furthermore, if we know that complete rest is necessary, why are we breaking from it?

    Ever since the NFL started taking concussions seriously, there has been a major swing in interest of how to prevent concussions. Unfortunately, I have a hard time believing that preventing a concussion will ever occur unless the athlete is removed from competition entirely. What we can do, is take a baseline test and use that for our athletes. ImPACT may prevent false positive tests and false negative tests. Even professional athletes such as Peyton Manning have come out and said that they have purposely failed the test so that they can fool their ATs and return to play sooner. Ask Brian Urlacher about his concussions, where he would use a known injury (i.e. turf toe) as an excuse as to why he’d sit on the bench for a few plays before returning to play with a known concussion.

    I mentioned a baseline testing for our athletes. I am an advocate for the SCAT 3 test as a baseline. It encompasses memory/recall, balance, and even includes a symptom checklist for the athlete to fill out. For those who want to do more, a King-Devick test can also be incorporated into a baseline. Again, these are only tools to aid us in the diagnosis of a concussion and can be used to aid the athlete in returning to play in conjunction with an established return to play protocol.

    I have attached two articles written by an amazing colleague, friend, and mentor of mine, Dr. Les Mayers who, in my opinion, was way ahead of his times in regard to concussion research. He studied concussion and the use of ImPACT testing on collegiate athletes. The two studies pertain to ImPACT use and and the return to play criteria post-concussion.
  • I used to use ImPACT at a school I was previously at and have seen firsthand the issues these articles describe. Namely the test-retest learning curve. I also urge athletic trainers and other medical professionals managing head injuries to use many different tools in their belt to make guide them on the management and return to learn and return to play decisions. There is yet to be a single tool that does it all. That being said, usually 24-48 hours following an incident the scores of the concussed individual were obviously evident. Over the following week(s) the individual would retake it 1-3 more times on average. I would ask that the individual tell me when they felt symptom free and were not having any issues in class. This is usually when the second post test was conducted. I didn't want them to do it daily where they might improve due to practice. Also, why take a test on memory and reaction time to determine recovery when their reported symptoms were still present? Sometimes they would lie and tell me they had no symptoms, but would hope they could pass the test anyway. And some did. I usually found out about lingering headaches from a teammate. I sometimes found that even when I felt they were honest about having no symptoms, their ImPACT scores still indicated deficits and I held them out accordingly. Sometimes they would pass the ImPACT test, but exertional tests would bring back a symptom or two.

    I am with a different school district now and have investigated and now utilize SWAY Balance. It uses the accellerometers in an Apple device to measure balance and reaction time. The balance portion is basically a BESS test and it measures how much they sway and compares it to their personal baseline scores and not normative data. I have to say, it can detect very subtle differences where I would probably have passed them from my subjective assessment, but their scores are outside the confidence interval of their baselines. Three baselines are taken prior to the season and you just can't purposely score low because of the sensitivity of the program. The reaction time portion is done by holding the screen still and moving it when the screen changes color. If you are testing for a possible concussive event, it includes the SCAT 3 symptom checklist. It is portable and can be done on the sideline. Mass baseline testing is easy and much quicker than ImPACT. It is FDA approved as well. I am not a salesperson for SWAY, I just have been pleased with their product and the application of it. It is also a tool and used in conjunction with my other clinical and judgement tools.
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