ABSTRACT
This chapter provides practical information regarding interpreting change in concussed athletes. There are five fundamental issues and challenges that complicate the interpretation of change in sports neuropsychology: initial level of performance, practice effects, regression to the mean, measurement error, and response set. Focusing, dwelling, and worrying about symptoms of concussion, and “brain damage”, can magnify them and protract the recovery period. The Rivermead Symptom Checklist, hereafter referred to as the Rivermead, is printed as Appendix 6 in Wrightson and Gronwall’s book on mild head injury. The assessment of change is the sine qua non of clinical neuropsychology. The determination of change on neuropsychological tests and on self-report concussion symptom inventories is complex. The profession of clinical neuropsychology has a long history of over-interpreting and over-pathologizing change. In summary, there are numerous factors that neuropsychologists must be aware of when assessing post-concussion change in athletes using self-report inventories or performance-based measures.
