Ahead of the Game is a strong addition to the limited arsenal of useful references to help guide parents through the complex labyrinth of information about concussion in youths. Dr. Moser presents this text in an easily navigable format, with user-friendly titles and terms. While the content of the book may be intimidating for many parents, the format and writing style will not be overwhelming. Additionally, each chapter provides a review at the end, as well as useful tips, facts, and tables throughout. Parents in the midst of trying to educate themselves about this injury, preferably before they are faced with these issues, would likely be able to access individual components of the book as needed. This resource should be useful for parents and the public, as well as clinical neuropsychologists as a possible reference point for parents, community groups, and patient populations.
The first few pages of the work clearly present strong evidence, arguments, and examples of the seriousness of this injury and the associated issues. If a parent is picking up this book before needing to learn quickly how to manage an injury, the introduction will clearly explain why they should take the time to read this work. The chapters then follow a predictable but easily followed format, first laying out the scientific explanation of a concussion followed by chapters addressing the identification and treatment of concussion. The initial chapter's (Understanding the Young Brain) explanations of scientific terminology are in appropriate layman's descriptions. While this is not meant to be a textbook providing scientific details of the neurophysiology of concussion, scientific terms that an involved parent who uses the internet is likely to encounter are covered. Dr. Moser clearly states the goal of ensuring that a concussion is properly identified by a qualified medical professional. Her discussion of diagnosis consistently deflects this to individuals with qualifications for dealing with young athletes, and appropriately covers the differences in symptom presentation, symptom severity, and diagnostic tools. The addition of Chapter 3, which discusses the use of baseline testing, is a welcome conversation for parents in the whirlwind of media coverage. Dr. Moser clearly states her own professional affiliations, which accounts for much of her discussion. However, she appropriately acknowledges additional methods and resources, as well as also providing a clear discussion of the complexities of baseline comparisons.
With Chapter 4, Ahead of the Game provides much needed direct instructions for parents in the identification and treatment of concussions. An eight-step plan is clearly outlined, with logical comprehensive steps for parents, coaches, and athletes to follow, beginning with baseline testing prior to initiating the sports season. A case study helps illustrate the need for all eight steps. Additional discussion addresses the possible need for additional medical consultations, and begins to discuss alternative therapies, although the reader should be aware that this is not necessarily a comprehensive list. The discussion of academic accommodations is also an area of the book that will likely be marked for easy reference by parents. As such, it might have been stronger for this area to be a bit more comprehensive, with more examples of specific accommodations, moving from basic general suggestions to direct modifications that have been successful for various schools and athletes. Making return-to-play decisions encompasses the next chapter, and these significant ethical issues are covered well. A strong discussion about the true complexities of these decisions includes covering how to consider cases individually, including those with no prior injury and what to do when faced with considering retiring a young individual from certain athletic activities. The need for mental health intervention, cognitive therapy and balanced lifestyle are a bit underplayed in this area. The chapter entitled Drafting a Concussion Health Care Team contains a strong discussion of what professionals a parent should look for and what questions to ask them, although it admittedly may still be challenging for a parent to find some of these individuals. An excellent case study is presented that highlights how a team, or multi-disciplinary approach, would have been helpful, reinforcing its necessity.
The book ends with Dr. Moser presenting her Brain Hygiene Model which again emphasizes a culture shift toward understanding and respecting the growing, developing brain before injury strikes. This is a cause championed by all of us who work in neuropsychology, and particularly those of us in the front lines of concussion diagnosis and treatment. Her clear statements that the mom and neuropsychologist in her hopes “brain hygiene will become part of standard preventive care” (p. 12) are echoed by those of us in the field with the same roles and passions. This work will be an excellent addition to the must-read reference list for parents.