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In response to advancing clinical practice guidelines regarding concussion management, service members, like athletes, complete a baseline assessment prior to participating in high-risk activities. While several studies have established test stability in athletes, no investigation to date has examined the stability of baseline assessment scores in military cadets. The objective of this study was to assess the test–retest reliability of a baseline concussion test battery in cadets at U.S. Service Academies.
All cadets participating in the Concussion Assessment, Research, and Education (CARE) Consortium investigation completed a standard baseline battery that included memory, balance, symptom, and neurocognitive assessments. Annual baseline testing was completed during the first 3 years of the study. A two-way mixed-model analysis of variance (intraclass correlation coefficent (ICC)3,1) and Kappa statistics were used to assess the stability of the metrics at 1-year and 2-year time intervals.
ICC values for the 1-year test interval ranged from 0.28 to 0.67 and from 0.15 to 0.57 for the 2-year interval. Kappa values ranged from 0.16 to 0.21 for the 1-year interval and from 0.29 to 0.31 for the 2-year test interval. Across all measures, the observed effects were small, ranging from 0.01 to 0.44.
This investigation noted less than optimal reliability for the most common concussion baseline assessments. While none of the assessments met or exceeded the accepted clinical threshold, the effect sizes were relatively small suggesting an overlap in performance from year-to-year. As such, baseline assessments beyond the initial evaluation in cadets are not essential but could aid concussion diagnosis.
The close relationship between children's vocabulary size and their later academic success has led researchers to explore how vocabulary development might be promoted during the early school years. We describe a study that explored the effectiveness of naturalistic classroom storytelling as an instrument for teaching new vocabulary to 6- to 9-year-old children. We examined whether learning was facilitated by encountering new words in single versus multiple story contexts, or by the provision of age-appropriate definitions of words as they were encountered. Results showed that encountering words in stories on three occasions led to significant gains in word knowledge in children of all ages and abilities, and that learning was further enhanced across the board when teachers elaborated on the new words’ meanings by providing dictionary definitions. Our findings clarify how classroom storytelling activities can be a highly effective means of promoting vocabulary development.
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