"An easy twominute vision test administered on the sidelines after a young athlete has hit his or her head can help to reliably determine whether the athlete has sustained a concussion according to a new study of student athletes https some as young as . The test is so simple and inexpensive that any coach or parent potentially could administer it the studys authors believe and any league afford to provide it as a way to help evaluate and safeguard players.  Those of us who coach or care for young athletes know by now that an athlete who falls or collides with something during play or seems dazed dizzy loses consciousness or complains of head pain should be tested for a concussion which occurs when the brain is physically jostled within the skull. But most of us are clueless about how to test young athletes. The most commonly recommended sideline test is the Standardized Assessment of Concussion a multipart examination during which athletes are asked to name the date describe how they feel memorize and recall lists of words and do jumping jacks and other tests of coordination. Ideally this assessment should be administered and evaluated by a medical professional.  But while the sidelines of college and professional games are crowded with doctors and certified athletic trainers few high schools and youth leagues have those resources. Most of the time concussion testing in youth sports falls to volunteer coaches or parents with little if any medical experience. That situation prompted researchers at New York Universitys Langone Concussion Center https to begin wondering recently whether there might be other easier diagnostic tools to check young players for concussions. Their thoughts soon turned to vision.  About  percent of the brains pathways are tied in some to way to vision and visual processing said Dr. Steven Galetta chairman of neurology at N.Y.U. Langone Medical Center and senior author of the study which was published in The Journal of NeuroOphthalmology https  Eye tests can tell evaluators a great deal about how well someones brain is working. But for the most part visual tests have not been part of the standard protocol for sideline concussion testing of young athletes.  However the N.Y.U. researchers knew that in recent years trainers working with athletes in sports such as boxing and mixed martial arts where concussions are common had begun supplementing the Standardized Assessment with a simple vision exam known as the KingDevick test during which someone reads slightly jumbled lines of numbers printed on three cards as quickly as possible. See below for more information. The KingDevick test measures rapid eye movement visual tracking and related cognitive responses and is a reliable indicator of cognitive problems. If an injured adult reads the numbers more slowly after a head impact than in baseline testing he or she is considered to have sustained a concussion. The test requires no medical training. But it had not been evaluated for use in young athletes. So the N.Y.U. researchers decided to test it.  They recruited  young hockey and lacrosse players between the ages of  and  and  collegians from the same sports.  These athletes all completed a baseline Standardized Assessment of Concussion exam during preseason and walked as fast as possible along a narrow foot long strip of athletic tape to measure their balance. They also completed the KingDevick test.  Then they went out to play.  During their subsequent competitive seasons  athletes hit their heads and were put through the full battery of sideline concussion tests by parents or coaches under the supervision of N.Y.U. medical personnel. Fourteen agematched uninjured athletes in the same sports completed the same tests to serve as controls.  Neurologists later confirmed that the  injured athletes had sustained concussions. Then the N.Y.U. researchers compared how well the various sidelines tests had done at pinpointing the brain injury.  The Standardized Assessment of Concussion had performed rather miserably correctly identifying only two of the concussed athletes missing  and finding that three of the uninjured control athletes had supposedly sustained a concussion since their scores had declined compared with their baseline almost certainly the studys authors believe because these young athletes were physically tired.  The KingDevick test did much better correctly assessing concussion in  percent of the young injured players and inaccurately identifying it in only one.  The pacealongthetape test was also relatively accurate. Ten of the  injured athletes were slower now but so were five of the unhurt players.  Overall the KingDevick test had by far the greatest accuracy and lowest risk of false positives.  The upshot Dr. Galetta believes is that parents and coaches should absolutely consider familiarizing themselves with the KingDevick test and administering it to young athletes before the season starts then having those baseline numbers and the test itself handy on the sidelines. If an athlete hits his or her head and is then slower than baseline by even a fraction of a second at reading off the numbers Dr. Galetta said it is very probable he or she has a concussion and needs to be taken from play and seen by a doctor.  It is still too early to say however whether the KingDevick test can replace other more conventional concussion evaluations for young athletes including the standardized assessment despite its shortcomings in this study Dr. Galetta cautioned. For now he says it probably should be used in conjunction with other tests.    How to Administer the KingDevick Concussion Test  During preseason use a stopwatch to time the athlete as he or she reads off the numbers on each line from left to right as quickly as possible. The cards should be read in order. This establishes a baseline time. For the greatest precision you might want to have athletes perform the test twice and use their best reading.  During the season if an athlete is suspected of sustaining a concussion have him or her repeat the test on the sidelines. If the time is slower even by a small amount he or she probably has a concussion according to neurologists.  Interestingly uninjured athletes are almost always faster at reading the numbers during games or practices because physical exertion sharpens the kind of visual performance being tested."