The Handbook of Sport Neuropsychology is a unique volume. It takes as its mission the goal of describing the core concepts, competencies, and challenges in a new sub-specialty of care, sport neuropsychology. It is organized in four general categories: an overview of sport neuropsychology, in which the marriage of sport psychology to clinical neuropsychology is proposed (Overview), a section with chapters addressing various clinical issues in sport-related concussion, two chapters on counseling and therapy issues, and a final section entitled New Directions in Sport Neuropsychology.
The marriage of sport psychology and clinical neuropsychology is ambitious. The chapters do a good job of highlighting the natural overlaps, the differences, and the opportunities in both disciplines. Sport psychology involves both performance enhancement and clinical issues with the latter fitting more easily into the clinical neuropsychology model. The basic descriptions of issues, competencies, and procedures here are good, and the neuropsychologist-reader should come away with a much better perspective of the discipline of sport psychology and how these two specialties share territory. A chapter on ethical issues is also well developed. Indeed, ethics take on a broader and somewhat different scope when dealing with athletes, teams, and personal well-being, not to mention the socio-cultural milieu surrounding sports.
The largest section details sport-related concussions from history, to pathophysiology, imaging, assessment (including computerized assessment), management in youth, collegiate, and professional environments, and the clinical phenomena of multiple concussions. The chapters are informative and provide a balanced view of issues in diagnosis, assessment, repeat concussions, computerized testing, and imaging. In Chapter 8, Dr. Iverson reminds us of the importance of empirical validation of our tools, and why neuropsychology is an empirical science that informs clinical work. He reviews the broad types of tools (symptom-rating scales, neuropsychological testing, and balance testing), with a keen eye towards the psychometric properties and diagnostic utility of the most common tools. While not all tests and procedures are covered, the point is clearly that our responsibility as neuropsychologists is to use empirical evidence to drive our practice and decision-making. Two chapters discuss concussion management in youth sports, and in college and professional sports. Drs. Moser, Fryer, and Berardinelli describe the Centers for Disease Control's concerns about youth concussions, and try to be clear about what is not known and what makes good clinical sense (Chapter 11). The chapter on collegiate and professional concussion management programs captures the basic framework for providing sport concussion services at the collegiate level. The review on concussion research in college and professional athletes is well-worth reading and is organized in an effective manner. Obviously, more current studies are now available, but this review is nicely done.
Section 3 deals with counseling and therapy issues. The uniqueness of sport psychology and the clinical needs of athletes are well described. The emotional issues generated in high-performance activities are unique and deserve specialized attention. Therapeutic approaches are described and data on the emotional effect of concussions is provided. The emotional trajectory and course of concussed athletes highlights the need for a broader clinical approach than just neuropsychological testing. While brief, this section reiterates the comprehensive nature of sport neuropsychology.
The final section addresses new directions in sport neuropsychology. A case study of soccer heading in children touches on the intersection of science and politics that have become so prevalent in this sub-specialty. Legal and practical issues from the viewpoint of an athletic department are an extremely important chapter. This chapter highlights the structure of university athletics and the roles of various participants. It should be read together with the chapter on concussion management in collegiate sports, as this chapter provides the framework for understanding how a program must fit in and operate. The chapter on neuromotor effects of concussion addresses a topic that is often ancillary to neuropsychological assessment: balance and postural control. Since balance has become an important clinical entity in concussion identification, this chapter serves as a good overview of the theory, practice, and research on this topic. The next-to-last chapter discusses the value of games and sports in cognitive and behavioral development. While these may be topics that most pediatric neuropsychologists are familiar with, it may be less familiar to neuropsychologists who primarily work with older adolescents and adults. The growing outcry against concussions has often come across as an anti-sport chorus. This chapter reinvigorates the debate on the side of that which is important about sports.
Dr. Webb wraps up the volume discussing his view of the future of sports neuropsychology. As someone who has been at the nexus of this development, he has a full perspective. He provides valuable insight into the burgeoning legislative initiatives sweeping the country, he calls for policy based on science and for clinicians taking a more active roll in educating the public and stake-holders. Beyond the unique conceptual framework of this volume, the assembled authors provide a series of chapters that are both practical and informative for the interested young professional to the seasoned veteran. While issues related to performance enhancement are not included in this volume (e.g., neuropsychological effects and processes of exogenous and endogenous agents to facilitate performance improvement, the neuropsychology of expertise), both the perspective and the scope of this volume are well conceived and executed. This book provides an important platform for developing expertise in a fascinating and growing field. It is required reading from my students.