Endorsement Rates Research Articles

Validation of the blended learning usability evaluation – questionnaire (BLUE-Q) through an innovative Bayesian questionnaire validation approach: a methodological study

The primary aim of this study is to validate the Blended Learning Usability Evaluation - Questionnaire (BLUE-Q) for use in the field of health professions education through a Bayesian approach. As Bayesian questionnaire validation remains elusive, a secondary aim of this article is to serve as a simplified tutorial for engaging in such validation practices in health professions education. A total of 10 health education-based experts in blended learning were recruited to participate in a 30-minute interviewer-administered survey. On a 5-point Likert scale, experts rated how well they perceived each item of the BLUE-Q to reflect its underlying usability domain (i.e., effectiveness, efficiency, satisfaction, accessibility, organization, and learner experience). Ratings were descriptively analyzed and converted into beta prior distributions. Participants were also given the option to provide qualitative comments for each item. After reviewing the computed expert prior distributions, 31 quantitative items were identified as having a probability of 'low endorsement' and were thus removed from the questionnaire. Additionally, qualitative comments were used to revise the phrasing and order of items to ensure clarity and logical flow. The BLUE-Q's final version comprises 23 Likert-scale items and 6 open-ended items. Questionnaire validation can generally be a complex, time-consuming, and costly process, inhibiting many from engaging in proper validation practices. In this study, we demonstrate that a Bayesian questionnaire validation approach can be a simple, resource-efficient, yet rigorous solution to validating a tool for content and item-domain correlation through the elicitation of domain expert endorsement ratings.

Public attitudes and knowledge about self-injury: A cross-sectional web-based survey of Japanese adults.

Nonsuicidal self-injury is common among adolescents. Dispelling related public misconceptions is essential for creating effective prevention and intervention strategies, as these myths contribute to stigmatization. This study examined the prevalence of self-injury myths among the Japanese public and explored how demographics and personal experiences influence these beliefs. A nationwide web-based self-report survey of 2000 Japanese adults (mean age = 44.6 ± 14.3 years) examined their agreement with 14 scientifically unsupported self-injury beliefs. Endorsement rates for each myth were calculated, and the associations between myth beliefs and other variables were explored. Fourteen myths were analyzed, with endorsement rates of 21.0%-68.7%. Logistic regression analysis indicated that men were more likely to endorse the myth that self-injury is uncommon (adjusted odds ratio [AOR] = 1.45, 95% confidence interval [CI] = 1.17-1.79), whereas women were more prone to myths about the rarity of self-injury, using a single method, stimulation as the exclusive purpose, wrist-cutting prevalence, and average onset age. Younger participants were more likely to believe that self-injury is solely for stimulation than other age groups. Those with human-service professional experience were more likely to view self-injury as attention-seeking compared to those without such experience (AOR = 1.62, 95% CI = 1.07-2.46). With some exceptions, individuals who expressed confidence in their ability to respond to self-injurers were more likely to endorse the myths. These findings highlight the need for targeted educational interventions to dispel misconceptions about self-injury and improve public understanding of this complex behavior.

Development of an Inconsistent Responding Scale for the Big Five Inventory-2

The Big Five Inventory − 2 (BFI-2) is a commonly used self-report assessment of normal personality trait domains (Extraversion, Agreeableness, Conscientiousness, Negative Emotionality, Open-Mindedness) and facets. To date, however, no direct measures of response distortion have been developed for it to identify potentially invalid responses. Such distortions (e.g., careless or random responding) can adversely impact data quality. The current study developed and provided initial validation data for an inconsistent responding scale within the BFI-2 to identify careless responders using two large undergraduate samples and a community sample. To create the scale, we first identified highly correlated BFI-2 item pairs in one undergraduate sample (N = 1,461) and then computed a total score by summing the absolute differences of these item pairs. This scale, the Detection of Response Inconsistency Procedure (DRIP), differentiated randomly generated and genuine data and generally correlated as expected with personality domains and other inconsistent responding scales across samples. The DRIP also incrementally predicted random data beyond a composite of items with exceptionally high or low base rates of endorsement from the Comprehensive Infrequency/Frequency Item Repository. We provide recommendations for DRIP cut scores that can detect careless responding while balancing sensitivity and specificity.

Improving posttraumatic stress disorder assessment in young children: comparing measures and identifying clinically-relevant symptoms in children ages six and under

Young children exposed to trauma are vulnerable to developing posttraumatic stress disorder (PTSD). Although experts agree on the importance of tailoring PTSD assessments to be developmentally-appropriate for young children, there is little research on which assessment methods best identify clinically significant symptomatology in this difficult-to-assess population. Two competing models for assessing PTSD have been proposed by the DSM-5 and ICD-11. This study compared a DSM-5 measure to an ICD-11 measure in young children (ages 1–6) exposed to a natural disaster. The measures identified similar rates of PTSD in children; however, diagnostic agreement between the measures was low (31–36%). Both PTSD measures were associated with actual and perceived life threat, functional impairment, and comorbid psychopathology. PTSD symptom and cluster endorsement rates were also binned by age and compared to functional impairment to identify commonly-reported and highly impairing symptoms in trauma-exposed young children, as potential candidates for inclusion in future revisions of diagnostic criteria. Across age ranges, increased clinginess post-trauma was the most commonly reported symptom and was associated with functional impairment. Arousal symptoms (startle, hypervigilance) and Re-experiencing symptoms (nightmares) also emerged as relevant for young children. Findings may contribute to efforts to improve assessment for PTSD in young children.

Validation of the ND-PAE Diagnosis in Children with Heavy Prenatal Alcohol Exposure.

This study evaluated criteria for neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE). Kable et al. (Child Psychiatry Hum Dev 55:426, 2022) assessed the validity of this diagnosis in a sample with low exposure to alcohol. The current study expanded this assessment to a sample with a wider age range and heavier alcohol exposure. Data were collected from participants (5-17years) with prenatal alcohol exposure (PAE) and typically developing controls at six Collaborative Initiative on Fetal Alcohol Spectrum Disorders sites using neuropsychological assessment and caregiver reports. Impairment was tested at 1SD, 1.5SD, and 2SD below the normative average and a modification of the adaptive functioning requirement was tested. Testing impairment at 1SD resulted in the highest endorsement rates in both groups. Our findings replicated the study by Kable et al. and show that current criteria captured a high rate of those with PAE and that requiring fewer adaptive functioning criteria resulted in higher sensitivity to PAE.

Confronting Alzheimer's Disease Risk in Women: A Feasibility Study of Memory Screening as Part of the Annual Gynecological Well-Woman Visit.

Objective: Routine health care visits offer the opportunity to screen older adults for symptoms of Alzheimer's disease (AD). Many women see their gynecologist as their primary health care provider. Given this unique relationship, the Women's Preventive Services Initiative and the American College of Obstetrics and Gynecology advocate for integrated care of women at all ages. It is well-established that women are at increased risk for AD, and memory screening of older women should be paramount in this effort. Research is needed to determine the feasibility and value of memory screening among older women at the well-woman visit. Materials and Methods: Women aged 60 and above completed a 5-item subjective memory screener at their well-woman visit at the Columbia University Integrated Women's Health Program. Women who endorsed any item were considered to have a positive screen and were given the option to pursue clinical evaluation. Rates of positive screens, item endorsement, and referral preferences were examined. Results: Of the 530 women approached, 521 agreed to complete the screener. Of those, 17.5% (n = 91) were classified as positive. The most frequently endorsed item was difficulty with memory or thinking compared with others the same age. Among women with positive screens, 57.5% were interested in pursuing clinical referrals to a memory specialist. Conclusion: Results support the feasibility and potential value of including subjective memory screening as part of a comprehensive well-woman program. Early identification of memory loss will enable investigation into the cause of memory symptoms and longitudinal monitoring of cognitive change.

A mixed methods evaluation of patient perspectives on the implementation of an electronic health record-integrated patient-reported symptom and needs monitoring program in cancer care

BackgroundAs cancer centers have increased focus on patient-centered, evidenced-based care, implementing efficient programs that facilitate effective patient-clinician communication remains critical. We implemented an electronic health record-integrated patient-reported symptom and needs monitoring program (‘cPRO’ for cancer patient-reported outcomes). To aid evaluation of cPRO implementation, we asked patients receiving care in one of three geographical regions of an academic healthcare system about their experiences.MethodsUsing a sequential mixed-methods approach, we collected feedback in two waves. Wave 1 included virtual focus groups and interviews with patients who had completed cPRO. In Wave 2, we administered a structured survey to systematically examine Wave 1 themes. All participants had a diagnosed malignancy and received at least 2 invitations to complete cPRO. We used rapid and traditional qualitative methods to analyze Wave 1 data and focused on identifying facilitators and barriers to cPRO implementation. Wave 2 data were analyzed descriptively.ResultsParticipants (n = 180) were on average 62.9 years old; were majority female, White, non-Hispanic, and married; and represented various cancer types and phases of treatment. Wave 1 participants (n = 37) identified facilitators, including cPRO’s perceived value and favorable usability, and barriers, including confusion about cPRO’s purpose and various considerations for responding. High levels of clinician engagement with, and patient education on, cPRO were described as facilitators while low levels were described as barriers. Wave 2 (n = 143) data demonstrated high endorsement rates of cPRO’s usability on domains such as navigability (91.6%), comprehensibility (98.7%), and relevance (82.4%). Wave 2 data also indicated low rates of understanding cPRO’s purpose (56.7%), education from care teams about cPRO (22.5%), and discussing results of cPRO with care teams (16.3%).ConclusionsWhile patients reported high value and ease of use when completing cPRO, they also reported areas of confusion, emphasizing the importance of patient education on the purpose and use of cPRO and clinician engagement to sustain participation. These results guided successful implementation changes and will inform future improvements.

Proneness to false memory generation predicts pseudoscientific belief endorsement

Among cognitive factors that can influence the endorsement of pseudoscientific beliefs, our study focuses on proneness to false memory generation. In this preregistered study, we presented 170 fluent English speakers residing in the USA with a misinformation task aimed at generating false memories. In this task, they first completed an event encoding stage, in which two events were narrated through sequentially presented pictures. One day later, they read a series of sentences relating the same events but which included several inaccurate descriptions aimed at producing a misinformation effect. Finally, we measured the influence of the misinformation manipulation over false memory generation. After completing the misinformation task, participants responded to a questionnaire measuring pseudoscientific beliefs. Our results showed a positive correlation between pseudoscience endorsement and false memory rates, which indicates that the latter might be a key factor influencing susceptibility to pseudoscience. To our knowledge, this is the first study showing a link between the tendency to believe in pseudoscience and variability regarding proneness to develop false memories. Practical implications for the design of new interventions to effectively reduce pseudoscientific beliefs and their negative impact on our society are discussed.

Sociodemographic correlates of parent and youth-reported eating disorder symptoms in the Adolescent Brain Cognitive Development Study.

Eating Disorders (EDs) often start in adolescence, though ED-related concerns in diverse youth samples remain understudied. We leveraged data from the Adolescent Brain Cognitive Development (ABCD) Study to identify the prevalence of parent- and youth-reported ED symptoms and their sociodemographic characteristics. Data were drawn from baseline (ages 9-11 years, n=11,868) and 2-year follow-up (ages 11-14 years; n=10,908) from the ABCD Study. A tetrachoric factor analysis summarized clusters of ED symptoms, which were compared between parent and youth reports and across sociodemographic variables. Three factors emerged reflecting "weight distress", "weight control", and "binge eating" (prevalence range: 1.5-7.3%). Symptoms loaded onto similar factors between reporters. Rates of symptom endorsement were similar between sexes, with disproportionately higher endorsement rates for youth who self-identified as sexual minority, Hispanic, Black, or Mixed race participants, and those from a disadvantaged socioeconomic background, compared to the reference ABCD sample. Youth and parent reports at 2-year showed ~12% overlap. ED-related concerns among historically understudied racial and sexual minority groups call for greater attention to the detection and treatment of these symptoms in these groups. Applying a transdiagnostic approach to ED symptoms can inform effective detection and intervention efforts.

Double reading performance and the impact of adjudication on progression-free survival estimations: Findings from a lung clinical trial.

e23010 Background: The FDA recommends Blinded Independent Central Review (BICR) with double read for clinical trials with imaging. However, inter-reader variability is a concern in these trials. While studies have investigated the variability of RECIST, the primary response criteria, little attention has been given to the optimal association of readers. The evaluation of therapeutic response in phase III trials relies on the Date of first Progressive Disease (DoPD), with the Discrepancy Rate (DR) as the preferred index for measuring inter-reader variability in DoPD evaluation. Another important index measures readers' bias, assessing their tendency to over or under-estimate diagnoses. In cases of discrepancies, a third reader is brought in for adjudication. However, the impact of adjudication on trials' Progression-Free Survival (PFS) is not well-documented. Our study examines the variability in a lung clinical trial using RECIST, analyzing double reading performance, reader association prediction, and the impact of adjudication on PFS estimations. Methods: We retrospectively analyzed five phase III lung clinical trials using the RECIST 1.1 criteria in BICR with double reads. The trials involved 7 readers organized into 11 teams, each reader having participated in multiple trials and performed over 50 reads, resulting in 1017 patients' reviews. Our analysis included: Calculation of DR and bias for each team, and testing the correlation between DR and bias. Computation of the signed bias for each individual reader. Evaluation of a probabilistic model to predict the DR for each team and the bias for each reader. Comparison of PFS between single and double reads after adjudication and endorsement of one of the readings. Results: A multiple comparisons test did not reveal any difference between teams’ DR (Marascuilo test; q > 0.05). The average DR across all teams was 39.9% [95%CI; 37.8; 41.9]. However, we did find significant differences in bias when comparing 9/55 pairs of teams (Marascuilo test; q < 0.05). The range of absolute bias values was 20% to 100%. We did not find a correlation between bias and DR (p = 0.64). Additionally, when comparing the average bias value per reader, no differences were observed (Marascuilo test; q < 0.05). We failed to predict teams DR and readers' bias. The endorsement rate of readers ranged [18%; 82%]. After adjudication, we found that 27% of the PFS were lower than the minimum value obtained from the single readers, in one case 20.6% shorter. Conclusions: Significant readers' bias has a notable impact on double readings, independent of the DR values. The performance of one reader cannot be generalized based on others. Additionally, adjudication significantly affects the PFS of clinical trials. These findings emphasize the importance of considering readers' bias and the potential consequences of adjudication in clinical trial assessments.

What determines voting behavior to host the Olympic games in the Rhine-Ruhr area: a multilevel model.

This study analyzes factors influencing public support for hosting the Summer Olympics in the Rhine-Ruhr (RR) region in 2036 or 2040. Analyzing data from 14 municipalities, a multilevel model is used to account for individual and contextual factors. Despite a high overall endorsement rate of 67%, the study shows that consumer capital, pride, perception of sustainability, and historical significance significantly influence voting behavior. Surprisingly, structural factors at the municipal level do not show a significant influence. This research provides valuable insights for policymakers and organizers considering future Olympic bids in the RR region. The results emphasize the importance of effective communication to gain public support. This communication should highlight the environmental and economic sustainability of the host community, historical significance, and intangible benefits such as pride.

Operationalization, implications and correlates of the cultural deviance criterion for ICD-11 and DSM-5 prolonged grief disorder

Prolonged Grief Disorder (PGD) is included in ICD-11 and DSM-5-TR and includes a requirement of cultural deviance. This study examined endorsement rates and factors associated with endorsement of this criterion among Danish bereaved spouses (n = 425) and their adult children (n = 159) four years post-loss. In total, 7.5% (n = 44) participants endorsed this criterion. Both including and excluding the criterion, the prevalence rates for probable DSM-5-TR PGD were 1.4% (n = 8) and 1.7% (n = 10), respectively and for probable ICD-11 PGD were 1.4% (n = 8) and 2.2% (n = 13), respectively. Age and gender of the deceased, age of the bereaved, greater grief severity, and comorbid psychopathology were positively associated with endorsement of the criterion. Findings demonstrate low endorsement of the cultural deviation criterion, that its inclusion excludes several potential PGD cases, and unanticipated associations with several factors raise questions about the criterion’s validity.

The prevalence of corporal punishment in Australia: Findings from a nationally representative survey

AbstractCorporal punishment is associated with adverse outcomes; however, little empirical data exists about the state of corporal punishment in Australia. This paper presents the first national prevalence estimates of experiences of corporal punishment during childhood among Australians and its use as adults by Australian parents and caregivers. We also report community beliefs about the necessity of corporal punishment. Results show corporal punishment remains common in Australia. A high proportion of Australians (62.5%) experienced corporal punishment in childhood, including almost 6 in 10 (58.4%) young people aged 16–24. Approximately half of all parents surveyed (53.7%) had used corporal punishment. A quarter of Australians (26.4%) believe corporal punishment is necessary to raise children, 73.6% do not view it as necessaryThe use of corporal punishment and belief in its necessity are lower among younger people. Findings indicate the experience of corporal punishment remains unacceptably high in Australia but that the use of corporal punishment and beliefs about its necessity may be changing. These findings have significant implications for policy and practice in Australia. Changes in legislation could reduce this form of violence toward children. Relatively low rates of endorsement of the necessity of corporal punishment suggest the Australian community may be receptive to attempts for law reform in this area.

Effects of Engagement Rate and Endorsement Rate on Social Media Endorsement Services on Indonesian Tax Compliance

As a matter of fact, the Indonesian tax compliance level is still low compared to the taxpayer population. Tax compliance is a mandatory requirement that must be met by taxpayers, who have met the subjective and objective tax requirements, including endorsers. Nowadays, endorsement services are becoming a popular job among Generation Z and Alpha, especially in Indonesia. Endorsement service income is influenced by the endorsement rate set by the endorser based on engagement rate on the endorser's social media. This paper aims to examine how engagement rate and endorsement rate on social media platforms contribute to Indonesian tax compliance with the endorser's income as a moderator. The results show that with the endorser's income as a moderator, engagement rate and endorsement rate significantly strengthened their influence on tax compliance. Furthermore, the endorser’s income itself did not significantly influence tax compliance, which means taxpayers' tax compliance behavior is not fixed by the endorser’s income. The possible impact of this study is to assess taxpayers understanding regarding endorsement service, especially endorsers, and to educate endorsers regarding the imposition of endorsement service tax to increase the tax compliance of Indonesians.

Prevalence rate trends of borderline personality disorder symptoms and self-injurious behaviors in college students from 2017 to 2021

The current study examines the prevalence rates of borderline personality disorder (BPD) symptoms and nonsuicidal self-injury (NSSI) behaviors amongst college students over a five-year period, including pre- and during the COVID pandemic. Online prescreener surveys were completed by undergraduate students (n = 12,756) attending a large Southern Plains University every semester from Spring of 2017 to Spring of 2021. The percentage of students with NSSI history and significant BPD symptoms were visualized by semester to examine trends over time. A series of logistic regressions and negative binomial regressions were conducted on NSSI history and BPD symptoms to examine whether the endorsement rates have been increasing over time and to compare before and during COVID pandemic. There was an increasing trend of NSSI rates and significant BPD symptoms over time for all sexes. Furthermore, there was a steeper increase in BPD symptoms specifically in female students over the last five years. Additionally, there was a significant increase in odds of elevated BPD symptoms and NSSI behaviors in the college students enrolled during the COVID pandemic compared with pre-COVID. Overall, there has been an increasing trend in BPD symptoms and NSSI rates over the last few years, including during the COVID pandemic.

Formal versus informal pathways to mental health care in China

ABSTRACT The reported 20% prevalence rate of diagnosable mental illnesses in China might be underestimated due to individuals’ hesitation to report mental health problems. This study tested whether a person’s mental health diagnosis would lead to endorsement and preference for professional care. A community-based survey was conducted in Shanghai, China (n = 466). A structural model showed that 68.8% of the respondents endorsed professional help. Male respondents had a lower endorsement rate for individuals diagnosed with substance use compared to PTSD, suicide, or schizophrenia. Female respondents showed a higher endorsement rate on formal care for schizophrenia compared to PTSD or depression. In the models between health and mental health care, 34% of the respondents endorsed health care, whereas 46% of the respondents endorsed mental health care, with helping-seeking attitudes and age being significant covariates. In China, resources allocated to public education may improve acceptance of professional pathways to mental health care.

Heterogeneity in Measures and Rates of Reported Dementia and Subjective Memory Complaints Across U.S. National Surveys.

Several U.S. health surveillance surveys contain items related to self- and proxy reports of dementia and subjective memory complaints (SMC). Despite their similar content, these items differ in terminology, item specificity, and time frame. The goal of this study was to analyze whether item features might influence endorsement rates for dementia and SMC. We calculated design-appropriate estimates for the endorsement of dementia and SMC across U.S.-based national surveys and employed pairwise comparisons to evaluate endorsement rates across surveys. We also examined item characteristics to explore possible effects on endorsement rates. Endorsement rates were wide-ranging for dementia (ranging from 2.7% to 9.9%) and SMC (5.6% to 46.6%). Pairwise comparisons revealed statistically significant differences on most dementia-related items (76%), and all SMC comparisons (100%). Items varied substantially in the terminology used to assess dementia and SMC (e.g., "dementia" vs "Alzheimer's disease") and used different time frames (e.g., "past month" vs "5 years"). National survey data on reported dementia and SMC can have important research, training, and policy implications, yet endorsement rates vary widely across surveys. That variability could emerge from subtle but influential item characteristics, and our findings highlight the need for item harmonization, in even their most basic characteristics. Standardizing items across national surveillance surveys facilitates comparison across surveys so that we can better understand the true burden of these conditions to inform public health initiatives.

Goals and Reasons for Entering Inpatient Withdrawal Treatment, and Perceptions of Help Received

Objective Abstinence has been the primary treatment goal for alcohol and other drug (AOD) users attending withdrawal treatment. However, other outcomes including harm reduction have also been identified. This observational study aimed to describe participants’ goals and reasons for seeking inpatient withdrawal treatment and compare the needs of clients with comorbid mental health problems and those without. Methods Participants completed questionnaires at intake and discharge. Questionnaires assessed reasons for entering withdrawal treatment, goals, comorbidity, and perceived help received. Results The sample comprised 1746 participants (69.4% male). Participants endorsed diverse reasons for entering withdrawal treatment. The most and least endorsed reasons were “stop using” (97.9%) and “legal reasons” (43.1%). Comorbidity groups varied significantly in their endorsement of reasons for mental health, physical health, harm reduction, financial, and legal. Conclusion AOD users enter withdrawal treatment with a variety of reasons and goals including harm reduction. Variations in rates of endorsement highlight the importance of identifying individual needs dependent on mental health comorbidity.

Investigating the latent structure of the International Trauma Questionnaire to assess ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD in an adult civilian sample during the Ukraine war.

The symptom structure of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) and the validity of the International Trauma Questionnaire (ITQ) are yet to be tested among civilians in an active war zone. The present investigation examined the factor structure of the ITQ, the internal consistency of observed scores, and their associations with demographic characteristics and war-related experiences using a nationwide sample of 2,004 adults from the general population of Ukraine approximately 6 months after the full-scale Russian invasion in 2022. Overall, rates of endorsement across all symptom clusters were high. The mean total number of war-related stressors reported was 9.07 (SD = 4.35, range: 1-26). Internal reliability was good for all six ITQ subscales, Cronbach's αs = .73-.88, and the correlated six-factor model was found to provide the best representation of the latent structure of the ITQ in the present sample based on fit indices. There was evidence of a dose-response relationship, with increasing scores on all symptom clusters associated with higher total reported war-related stressors.

A-35 Difficulty Speaking, Stuttering, and Missing Words Post-Concussion: Findings from Two Independent Studies

Abstract Purpose The current investigation examined the potential consequences of concussion on speech-language abilities by analyzing quantitative and qualitative data from two independent studies. Methods Study 1: 185 rugby, soccer, football, rowing, and hockey athletes (M=17.42 years, SD=3.80; 44% female) completed the Rosenbaum Concussion Attitude and Knowledge Survey (RoCKAS). Study 2: 19 varsity soccer, rugby, volleyball, and basketball athletes (M=21.74 years, SD=2.13; 37% female) with history of at least one concussion completed individual one-hour semi-structured interviews, and thematic analysis was used to identify patterns across athletes’ experiences of concussion. Results Study 1: Quantitative analysis of athletes’ endorsements of distractor and legitimate post-concussive symptoms on the RoCKAS yielded a relatively low rate of endorsement across all distractor symptoms (1–29%, M=11%), with the exception of ‘difficulty speaking’, which was endorsed by majority (70%) of the sample. Study 2: Thematic analysis of interview content identified long-term difficulties with speech articulation (i.e., stuttering and word-finding) as a post-concussive symptom for 42% of the sample. Conclusions While speech abilities are largely thought to remain intact following concussion, quantitative and qualitative findings from these two independent studies suggest that speech difficulties may be an overlooked outcome of concussion. Several neuropsychological (e.g., attention, memory, executive function, or processing speed) and neuropathophysiological (e.g., diffuse axonal damage to cortico-subcortical pathways) processes may be underlying this relationship. Exploratory studies and longitudinal data are needed to elucidate the potential consequences of concussion on speech-language abilities.