Non-physiological Speech Disturbance in Teen Athletes with Concussion: A Case Series
Bibliographic record
Abstract
Objective This report is intended to share unique patient cases featuring a common but inadequately researched problem in adolescents with concussion. Background Despite evidence associating concussion with increased risk of mental illness, the literature has limited information examining functional speech disorder as a sequala of concussion in teen athletes [Table 1]. Design/Methods A PubMed search was completed using the following key words: functional speech disorder, conversion disorder, concussion, pediatrics. A total of five articles resulted and were reviewed. Results A 14yo female with a concussion from volleyball had a protracted course of recovery due to anxiety. Months later, she was struck by a tennis ball without a second concussion. She developed a non-physiologic stutter and atasia-abasia. She recovered with cognitive behavioral therapy (CBT). A 16yo female with history of depression sustained a concussion playing soccer with an associated slurred speech. Two weeks later, her initial concussion symptoms resolved however she began stuttering. She was treated by adjusting her psychiatric medications. Two years later she sustained another concussion which caused a reoccurrence of stuttering. Symptoms improved after a partial day program with psychiatry and intensive speech therapy. An 18yo male wrestler with no psychiatric history suffered a concussion. He developed catatonia with echolalia. He was unable to participate in CBT, however symptoms have partially improved with diazepam. Conclusions This series highlights pediatric athletes presenting with functional speech disorders after concussion or an event triggering anxiety of concussion. The development of conversion disorder of speech was independent of any pre-disposing psychiatric history. Psychological treatment with CBT or medication successfully improved conditions in all cases. Providers should counsel patients and families of potential stress-response symptoms that can occur with concussion. Ongoing research is needed to establish patterns of these conditions and provide evidenced based guidelines to best direct treatment of these young athletes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".