Concussion / Mild Traumatic Brain Injury Guide: Assessment & Concussion Screening Tools

The following standardized tools are currently used by clinical professionals to assess athletes - both youth and adult - for concussion:

ACE

KING-DEVICK

VOMS

SCAT3

CHILD-SCAT3

Acute Concussion Evaluation

The ACE, developed by Gerald Giola and Micky Collins at the University of Pittsburgh Medical Center, is an evaluation tool for concussion in patients aged 3 to 18. The evaluation form itself is listed as Appendix A in the following article.

Citation: Gioia GA, Collins M, Isquith PK. Improving identification and diagnosis of
mild traumatic brain injury with evidence: psychometric support for the acute
concussion evaluation. J Head Trauma Rehabil. 2008 Jul-Aug;23(4):230-42. doi:
10.1097/01.HTR.0000327255.38881.ca. PubMed PMID: 18650767.

King-Devick Test

Developed in 1976 by two optometrists, Alan King and Stephen Devick, the King-Devick test found its first success with young children in detecting learning disabilities, including dyslexia.

From the King-Devick website:

"The King–Devick Test (K–D Test) is defined by Mosby’s Medical Dictionary as a tool for evaluation of saccade, consisting of a series of test cards of numbers. The test cards become progressively more difficult to read due to variability of spacing between the numbers. Both errors in reading and speed of reading are included in deriving a score. Saccades are quick, simultaneous movements of both eyes."

In 2011, researchers from the University of Pennsylvania Perelman School of Medicine used the King-Devick as a rapid sideline screening tool for mixed martial arts fighters and boxers. They found it an effective tool for identifying athletes with head trauma.

Citation: Galetta K, Barrett J, Allen M, Madda F, Delicata D, Balcer L, et al. The King-Devick test as a determinant of head trauma and concussion in boxers and MMA fighters. Neurology [serial on the Internet]. (2011, Apr 26), [cited April 20, 2015]; 76(17): 1456-1462. 

A Brief Vestibular/Ocular Motor Screening (VOMS) Assessment to Evaluate Concussion

This paper was published by the American Journal of Sports Medicine in October 2014 and provides a new & brief screening process to assess vestibular and ocular impairments after concussions.

Citation: Mucha A, Collins MW, Elbin RJ, Furman JM, Troutman-Enseki C, DeWolf RM, Marchetti G, Kontos AP. A Brief Vestibular/Ocular Motor Screening (VOMS) assessment to evaluate concussions: preliminary findings. Am J Sports Med. 2014 Oct;42(10):2479-86. doi: 10.1177/0363546514543775. 

Sport Concussion Assessment Tool - 3rd Edition

The SCAT3 is a standardized tool for for medical professionals, used to evaluate athletes aged 13 or older for concussion.

It is comprised of 8 metrics - including the Glasgow Coma scale, the Maddocks Score, and the Cognitive Assessment - which measure concussion symptoms.

This tool is currently used and endorsed by FIFA, IIHF, the International Rugby Board, and the Olympic Committee, among others.

Doctors are urged to get athletes immediate hospital care if the athlete presents with the following:

• Glasgow Coma score less than 15
• Deterioriating mental status
• Potential spinal injury
• Progressive, worsening symptoms or new neurological signs

Sport Concussion Assessment Tool - 3rd edition, for children ages 5 to 12 years

The Child-SCAT3 is a standardized tool for for medical professionals, used to evaluate athletes between the ages of 5 and 12 for concussion.

Doctors are urged to get children immediate hospital care if he/she presents with the following:

- Glasgow Coma score less than 15
- deteriorating mental status
- potential spinal injury
- progressive, worsening symptoms or new neurologic signs
- persistent vomiting
- evidence of skull fracture
- post traumatic seizures
- coagulopathy
- history of neurosurgery (e.g. shunt)
- multiple injuries

This is a concussion recognition tool approved by the same governing organization that developed the SCAT3.

It is small enough to fit in a wallet or purse.