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Where does the Speech-Language Pathologist Fit in Concussion Management?

Where does the Speech-Language Pathologist Fit in Concussion Management?
Miriam A. Carroll-Alfano, MS, CCC-SLP
February 19, 2016

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Overview and Learning Outcomes

Miriam: Thank you very much, Amy, and thank you to everyone for joining me today. As Amy mentioned, we are going to be talking about how the speech-language pathologist fits into concussion management.

Some people might say, “Of course we fit into concussion management and treatment!” without any question. However, speech-language pathologists are often not listed as one of the primary professions involved with concussion. We will talk about that more today.

These are our learning outcomes: We are going to be defining concussion, and differentiating between concussion and other traumatic brain injuries (TBI).  We will be naming the symptoms of concussion and their consequences.  We are going to identify the role of the speech-language pathologist in the prevention, assessment, and treatment of concussion. Lastly, we will talk about tools for assessment and treatment that can be used to help people who have sustained a concussion. There is an outline of the agenda in your slides.           


Before we get started, I wanted to do a survey of our audience today to see what areas you are working in. If you are an SLP who is working in a school, could you please let me know? If you are in a medical setting, could you please let me know by giving me the thumbs up this time? Okay, great. It looks like today we have more people who are working in schools than medical settings.

Just so you know, my background has primarily been in the medical setting.  I have worked with students - primarily high school and college-aged students - who have sustained concussion, as well as adults.  A lot of what we are going to talk about today, though, does relate to students, and returning to school, and different issues that happen with students with concussion. Also, some of the things that we will talk about today can be applied to adults as well.


There is a lot of talk about concussion, and The Centers for Disease Control and Prevention (CDC) estimate that between 1.6 and 3.8 million concussions occur annually as a result of participation in sports and recreational activities. If you look at those numbers, it is really a broad range. Part of the problem is that it is really difficult to pinpoint exactly how many concussions are occurring annually.

Part of that issue has to do with the fact that the CDC can track concussions if a person is treated in an emergency room or hospital, but if the person is treated by a physician, an athletic trainer or some other healthcare professional, the CDC cannot really track those numbers.  This is why there is such a big range of numbers for concussions.

Also, we know a lot of concussions actually still go unreported. There have been several studies that have found athletes often do not report it when they are having symptoms of a concussion. There are many reasons for this. Perhaps the athlete does not want to be removed from play. Perhaps the athlete has a lack of knowledge about concussion symptoms, so they might not even recognize that they are having a concussion.  This also all relates to attitudes of coaches, parents, and teammates.  If the attitude is “Shake it off, get back in the game,” someone may be less likely to report that they have sustained a concussion or that they think something is wrong.

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miriam a carroll alfano

Miriam A. Carroll-Alfano, MS, CCC-SLP

Miriam Carroll-Alfano is a medical speech-language pathologist with over 15 years of experience in hospital, acute rehabilitation, outpatient and skilled nursing facilities.  She has been a clinical faculty member at Saint Xavier University for 8 years supervising students in the clinic and teaching courses in adult neurogenic disorders including traumatic brain injury, stroke and dysphagia.  She is the developer and coordinator of the university’s Concussion Education Program and annually provides concussion training to all university athletes.  Miriam is currently working on her doctorate in Interdisciplinary Health Science at Western Michigan  University.  Her research interests include: concussion education and policy, assessment and treatment of concussion. 

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