Purpose: Concussion is the most common type of traumatic brain injury and results from impact or impulsive forces. Due to the variability and subtlety of symptoms, concussions may go unrecognized or ignored, especially if pressure is placed on an athlete to return to competition. These factors indicate a reliable and rapid screening tool is needed. The King-Devick (KD) test, a rapid concussion screening test, has been validated in collegiate and high school athletes. We report on a prospective study designed to test the feasibility of using this test as a screening tool in middle school football players.

Methods and Study Design: 62 male athletes from four local middle school football teams were recruited to participate. Athletes were given baseline testing prior to competition. Standard team protocol was used to diagnose concussions. Immediately after diagnosis, the test was re-administered. For comparison, non-concussed athletes also had repeat testing performed throughout the season.

Results: Seven diagnosed concussions occurred during one football season. In all seven concussed players, the cumulative read times for the KD test were significantly increased (p = 0.004). Testing of non-concussed athletes revealed minimal, but significant change in read times. In these players, read times were decreased compared to baseline, in what has been termed a “learning effect”.

Conclusions: Despite this “learning effect”, the KD test appears to be a suitable sideline screening tool for concussion in middle school football players.

Significance of Findings: Screening tools, such as the KD test, appear to be valid in younger age groups. Utilization of such screening tools may be important in early identification of TBI and alteration of the normal progression of such problems for lifelong athletes.

Summary Points:

  • The King-Devick (K-D) Test, a rapid concussion screening test, has been validated in collegiate and high school athletes. This study looked at K-D Test performance in middle school football players.
  • All concussed players (n=7) had significantly increased (worse) K-D Test cumulative times.
  • Non-concussed athletes revealed decreases in K-D test times, which was attributed to the learning effect.
  • The K-D Test is a suitable sideline screening tool for concussion in middle school football players.