Flash Card Concussion Test Brings Simplicity, Accuracy to Sideline

The simple assessment can be performed by trainers, coaches, and parents alike.

In a week that’s seen its fair share of brain injury news, a new study, published in the Journal of Neuro-Ophthalmology, claims that a simple flash card assessment could help trainers, coaches, and parents alike identify concussion right on the sideline.

Use of the King-Devick test (K-D), a vision-based evaluation of rapid number naming, on a group of 332 youth and collegiate athletes yielded impressive results: the K-D test showed the greatest capacity to distinguish concussed vs. non-concussed athletes compared to the Standardized Assessment of Concussion (SAC) and timed tandem gait tests, both of which are components of the Sport Concussion Assessment Tool, 3rd Edition (SCAT3 and Child-SCAT3).

Researchers conducted baseline testing on 243 youth ice hockey and lacrosse players aged 5 to 17 and 89 collegiate athletes aged 18 to 23. All of the participants were assessed with the K-D test, SAC, and timed tandem gait test prior to the athletic season. Athletes that sustained a concussion were retested on the sideline, and non-concussed athletes served as controls.

Among the 332 athletes, baseline time scores of the K-D test were better in older athletes. K-D scores worsened by an average of 5.2 seconds from baseline for the 12 athletes who sustained a concussion, while K-D scores improved by 6.4 seconds in the non-concussed controls. The K-D test ultimately showed the greatest capacity to distinguish between injured athletes and those with no concussive injuries (receiver operating characteristic [ROC] curve areas from logistic regression models, accounting for age = 0.92 for K-D, 0.87 for timed tandem gait, and 0.68 for SAC; P = 0.0004 for comparison of ROC curve areas).

The simple assessment, which doesn’t require medical knowledge to conduct or evaluate, may be especially useful in the youth sports arena where trainers and team physicians are few and far between. The rapid, low-tech evaluation may also help keep injured athletes from re-entering play and risking second impact syndrome, which can be fatal. 

For more information about concussion detection on the sidelines, go here


  1. Galetta KM et al. J Neuroophthalmol. 2015; doi:10.1097/WNO.0000000000000226.