New research authored by Drs. Moser and Schatz will be featured in the journal, Developmental Neuropsychology, entitled: “A Cross-Cultural Examination of Parental Knowledge of Concussion in Sicily, Italy” http://dx.doi.org/10.1080/87565641.2020.1789644.

COVID-19 Brain Effects With over a year of pandemic behind us, medical researchers are recognizing that COVID-19 infection affects the brain and may lead to pathological changes in brain physiology. Health care clinicians are documenting that many “recovered” patients are now complaining of persistent neuropsychological symptoms or “brain fog.” These neuropsychological symptoms fall into two domains: cognitive and emotional. Cognitive symptoms can include problems with attention/concentration, memory, processing speed, and executive functions, such as decision-making, problem-solving, planning, reasoning, inhibiting impulses, and multi-tasking. Emotional symptoms may include anxiety, depression, post-traumatic stress, and paranoia. Recent research has shown a variety of brain abnormalities due to the viral infection.1 Hypoperfusion, or reduced blood flow, has been observed in the frontal region of the brain, which regulates executive functions. Structural abnormalities have been seen in the temporal brain region, which is often referred to as “the seat of memory.” Also, demyelination, or erosion of the fatty coating that covers the nerves, may be the cause of slowed information processing speed. Source: Princeton Magazine. Read More...

Our Staff presented original research at the SNS 2023 Symposium in Denver, entitled “Criteria Determining Clinical Recovery From Concussion.”

Our Staff presented research on Clinical Recovery Decisions in Concussion at the BIANJ Annual Conference 2023.

Dr. Moser, President of SNS, was proud to present our research director, Dr. Philip Schatz with the SNS Distinguished Career Award, here with ED Dr. Donna Broshek.

Dr. Rosemarie Moser, far right, president of the Sports Neuropsychology Society, met with her Executive Board for their Mid-Year Meeting in St. Petersburg, Florida, January 20-21. 2023.

Dr. Philip Schatz, Director of Research, presented our new research about clinical decision-making in concussion recovery at the Concussion In Sport Group International Conference in Amsterdam in October, 2022.

By Dr. Rosemarie Scolaro Moser and Dr. Bridget Mayer Appearing in Princeton Magazine, Sept.2022 issue Dr. Bridget Mayer (BM): Congratulations on becoming elected as president of the Sports Neuropsychology Society! I suspect some readers of Princeton Magazine have never heard of sports neuropsychology. Dr. Rosemarie Scolaro Moser (RSM): Thank you and I don’t doubt you are right. Sports neuropsychology is a specialized field of health care that focuses on the brain health and emotional well- being of athletes of all ages and of all skill levels, whether pee wee, travel, community, high school, college, or pro sports. Sports neuropsychologists helped launch the first programs for concussion testing, identification, treatment, and research in professional athletes back in the 1990s. Soon after, we brought those programs to youth and amateur sports. But we are not only experts in concussion management and brain injury. We are focused on keeping athletes’ brains healthy and promoting emotional well-being. BM: Keeping athletes’ brains healthy is not an easy task, yet it’s critical to emotional well-being. I try to explain that the brain is an extraordinary, complex organ comprised of billions of nerve cells called neurons. These nerve cells connect to send electrochemical messages throughout the nervous system. Basically, the brain is the master controller of everything your body does and feels: your sensations, movements, thoughts, behaviors, and emotions. When your brain neurochemistry gets rattled, all kinds of quirky symptoms can occur: physical, cognitive, behavioral, and emotional. RSM: Yes! And we need to remember that concussions are not the only things that can disturb your brain neurochemistry. There are other factors to consider like diet, stress, physical injury, hormonal changes, substance and alcohol use, disease, and especially poor sleep. Unfortunately, we are a sleep-deprived culture, and lack of sleep wreaks havoc on brain neurochemistry. Disturbing your brain neurochemistry can result in a variety of symptoms like fatigue, poor focus and attention, learning difficulties, depression, anxiety, and memory problems. These symptoms will affect not only athletic performance, but academics, job performance, and family and social relationships. BM: The message here is that it is not just concussions that cause problems for athletes. Sports neuropsychologists help athletes identify and control the life factors that alter brain function and produce distress. In this way, athletes can improve overall performance and their physical and emotional well-being. I think the public is now becoming more aware of the stress on athletes to perform and compete. RSM: I am gravely concerned that for too long we have overlooked the significant stressors and challenges affecting our athletes. Whether it’s overspecialization at a very young age, the college athletic recruitment process, or pressure to excel at all costs, athletes can be vulnerable to worry, anxiety, and depression. Also, the stories of abuse, trauma, suicide, eating disorders, drug use, stigmatization, racism, and prejudice are heartbreaking. These are what Dr. William Parham, the first ever Director of Mental Health and Wellness of the National Basketball Players Association, calls “hidden tattoos.” Many of us do not realize the enormity of the pressures of competition, the lack of privacy, the grueling practice and training schedules, the sleep deprivation, the isolation, the bullying, and the back- room politics that can target athletes whose passions and goals are at stake. BM: I really applaud those high-profile athletes, like Simone Biles, Michael Phelps, Lindsey Vonn, and Serena Williams, who are coming forward as advocates of emotional well-being for their fellow athletes. Now, we all need to step up to the plate and provide the supports they need. RSM: Here is my checklist of supports for athletes, and all of these items are equally important: Provide athletes with reasonable schedules that include plenty of sleep, regular down-time, and reduced pressure to perform. Provide mental health awareness training through webinars, podcasts, educational meetings, and printed materials. Allow for user-friendly, non-stigmatized access to counseling, psychotherapy, group workshops, and training in mindfulness, meditation, and relaxation training for stress reduction. Help athletes take care of their bodies with monitoring for concussion and other injuries, proper pain management, and good nutrition. Provide academic supports and accommodations so that athletes can keep up with their academics in the face of athletic demands. Last, but not least, encourage their talents and interests in other areas of life so their self-worth is not solely defined by the sport. It’s important to keep a diversified life portfolio.

Established in 2012, the Sports Neuropsychology Society (SNS) is a non-profit organization of professional sports neuropsychologists, allied health care providers, trainees, and other colleagues interested in the brain health of athletes. Our professional membership includes neuropsychologists who are active in concussion management, as well as in how brain function relates to emotional, physical, and cognitive well-being. Our Society promotes evidence-based clinical practice, advances in research, professional training, educational resources, and advocacy for the benefit of amateur and professional athletes. We connect athletes of all ages and the public to sports neuropsychologists.

Established in 2012, the Sports Neuropsychology Society (SNS) is a non-profit organization of professional sports neuropsychologists, allied health care providers, trainees, and other colleagues interested in the brain health of athletes. Our professional membership includes neuropsychologists who are active in concussion management, as well as in how brain function relates to emotional, physical, and cognitive well-being. Our Society promotes evidence-based clinical practice, advances in research, professional training, educational resources, and advocacy for the benefit of amateur and professional athletes. We connect athletes of all ages and the public to sports neuropsychologists. For more information: www.sportsneuropsychologysociety.com

Paying Attention to Attention By Drs. Rosemarie Scolaro Moser, Sarah Friedman & Christina Zebrowski Back to school time, that time of year when both youth and adults must bid a temporary farewell to vacation mode and attend to the business of school and work. For some, the transition is an easy one. For others, problems with rallying our attention make the transition difficult. We all experience occasions when our minds wander, or when we miss the details of conversations because we are preoccupied. At these times, our attention is interrupted by distractions. For some, this distractibility or loss of focus is frequent, persistent, and longstanding since childhood, disrupting normal daily activities. It can hamper our academic achievement and professional performance, place stress on relationships and jobs, and make the back to school transition agonizing both for students and parents. ADHD Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder, or pattern of brain functioning characterized by inattention, distractibility, and, in some cases, hyperactivity. Individuals identified with ADHD typically fall into one of three categories: Inattentive, Hyperactive/ Impulsive, or Combined. Inattentive ADHD is characterized by a failure to give close attention to details, to engage in active listening, or to see a task through to completion. Individuals often have trouble organizing tasks and activities, are forgetful, and are easily distracted. Hyperactive/ Impulsive ADHD is characterized by fidgetiness, chattiness, restlessness, difficulty remaining seated, and risk-taking. Combined ADHD is characterized by symptoms of inattention as well as hyperactivity and impulsivity. It is estimated that ADHD occurs in approximately 5 to 8 percent of the population. It is more frequently diagnosed in males than females, perhaps because males display more of the hyperactive symptoms that are easily identified. ADHD is not a modern disorder. Many believe that historical figures such as Pablo Picasso, Thomas Edison, Albert Einstein, and John F. Kennedy may have coped with ADHD, which has also been associated with creativity, spontaneity, innovation, and energetic qualities. Celebrities and contemporary figures such as Terry Bradshaw, James Carville, Justin Timberlake, Henry Winkler, Jim Carrey, Michael Phelps, and Adam Levine have also been identified with ADHD. ATTENTION BASICS Attention, the first step in capturing new information, is critical to learning and memory. With a lack of attention, new information cannot be stored in memory, and cannot be retrieved as needed. In this case, the problem is not with memory (or storage) per se, but poor initial attention (or encoding). There are also different types of attention depending on which body sense is registering the new information: visual (sight), auditory (hearing/listening), tactile (touch), olfactory (smell), and gustatory (taste). Attention concerns are usually associated with problems in visual and auditory attention. To help improve attention while studying: Remove games, electronics, and non-homework related materials from the desk. Be sure the desk is fully organized with all necessary work materials, before sitting down to study. Use of external organization aids such as calendars, whiteboards, bins, and colored folders may help to support organization. Use a white noise machine, electric fan, or soft classical music in the background to drown out distracting noises, voices, and conversations that may disrupt attention and focus. Noise canceling headphones may also be helpful. Program a timer or alarm to sound every 5 to 10 minutes to minimize daydreaming, check on wandering focus, and provide designated break times to reset focus on the task. Attention is highly influenced by the value of the stimulus. It is far easier to attend to information that is considered to be very important or very interesting. A student who is passionate about video games may be able to focus on them for hours at a time, yet be unable to focus on his or her teacher for five minutes in the classroom when the educational material seems monotonous, repetitious, or uninteresting. ACCURATE DIAGNOSIS AND TREATMENT ARE ESSENTIAL ADHD can often be misdiagnosed. Proper diagnosis is imperative in order to effectively treat and manage the symptoms of ADHD. Symptoms of attention difficulties are found in a wide array of disorders and diseases other than ADHD, which may include but are not limited to: hearing loss, depression, anxiety, stress, behavior disorder, brain impairment, concussion, dementia, autism, seizures, auditory processing difficulties, emotional trauma, learning and memory disorders, chronic sleep deprivation, and even normal aging. As an example of the serious implications of misdiagnosis, a student who appears inattentive, due to an undiagnosed auditory processing disorder, may be incorrectly prescribed ADHD stimulant medications. In order to most accurately diagnose ADHD, a clinical interview and completion of self- report checklists are not enough. It is important to conduct a comprehensive evaluation, which includes a broad range of neuropsychological tests that measure various aspects of attention, and assist in ruling out other potential causes. Based on the findings of testing, a tailored treatment plan can be developed to address the individual’s areas of functioning that are most affected by ADHD. Depending on the age and life stage of the individual, recommendations may include academic accommodations for school and for standardized testing, work accommodations, skill training, coaching, psychotherapy, behavior therapy, and mindfulness training. A medical-psychiatric consultation for possible pharmaceutical therapy may be considered and, in many cases, may be helpful. In addition, an ADHD academic or life coach can be instrumental in teaching compensatory strategies to manage distractibility, motivation, procrastination, and organizational difficulties. Director Rosemarie Scolaro Moser, PhD, right; Sarah Friedman, PsyD, left; and Christina Zebrowski, PsyD provide neuropsychological testing, psychotherapy, and academic coaching services at the RSM Psychology Center in Princeton. Source: https://issuu.com/witherspoonmediagroup/docs/princeton_magazine_september_2019_digital_issue_