Established in 2012, the Sports Neuropsychology Society (SNS) is a non-profit organization of professional sports neuropsychologists, allied health care providers, trainees, and other colleagues interested in the brain health of athletes. Our professional membership includes neuropsychologists who are active in concussion management, as well as in how brain function relates to emotional, physical, and cognitive well-being. Our Society promotes evidence-based clinical practice, advances in research, professional training, educational resources, and advocacy for the benefit of amateur and professional athletes. We connect athletes of all ages and the public to sports neuropsychologists. For more information: www.sportsneuropsychologysociety.com

Paying Attention to Attention By Drs. Rosemarie Scolaro Moser, Sarah Friedman & Christina Zebrowski Back to school time, that time of year when both youth and adults must bid a temporary farewell to vacation mode and attend to the business of school and work. For some, the transition is an easy one. For others, problems with rallying our attention make the transition difficult. We all experience occasions when our minds wander, or when we miss the details of conversations because we are preoccupied. At these times, our attention is interrupted by distractions. For some, this distractibility or loss of focus is frequent, persistent, and longstanding since childhood, disrupting normal daily activities. It can hamper our academic achievement and professional performance, place stress on relationships and jobs, and make the back to school transition agonizing both for students and parents. ADHD Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder, or pattern of brain functioning characterized by inattention, distractibility, and, in some cases, hyperactivity. Individuals identified with ADHD typically fall into one of three categories: Inattentive, Hyperactive/ Impulsive, or Combined. Inattentive ADHD is characterized by a failure to give close attention to details, to engage in active listening, or to see a task through to completion. Individuals often have trouble organizing tasks and activities, are forgetful, and are easily distracted. Hyperactive/ Impulsive ADHD is characterized by fidgetiness, chattiness, restlessness, difficulty remaining seated, and risk-taking. Combined ADHD is characterized by symptoms of inattention as well as hyperactivity and impulsivity. It is estimated that ADHD occurs in approximately 5 to 8 percent of the population. It is more frequently diagnosed in males than females, perhaps because males display more of the hyperactive symptoms that are easily identified. ADHD is not a modern disorder. Many believe that historical figures such as Pablo Picasso, Thomas Edison, Albert Einstein, and John F. Kennedy may have coped with ADHD, which has also been associated with creativity, spontaneity, innovation, and energetic qualities. Celebrities and contemporary figures such as Terry Bradshaw, James Carville, Justin Timberlake, Henry Winkler, Jim Carrey, Michael Phelps, and Adam Levine have also been identified with ADHD. ATTENTION BASICS Attention, the first step in capturing new information, is critical to learning and memory. With a lack of attention, new information cannot be stored in memory, and cannot be retrieved as needed. In this case, the problem is not with memory (or storage) per se, but poor initial attention (or encoding). There are also different types of attention depending on which body sense is registering the new information: visual (sight), auditory (hearing/listening), tactile (touch), olfactory (smell), and gustatory (taste). Attention concerns are usually associated with problems in visual and auditory attention. To help improve attention while studying: Remove games, electronics, and non-homework related materials from the desk. Be sure the desk is fully organized with all necessary work materials, before sitting down to study. Use of external organization aids such as calendars, whiteboards, bins, and colored folders may help to support organization. Use a white noise machine, electric fan, or soft classical music in the background to drown out distracting noises, voices, and conversations that may disrupt attention and focus. Noise canceling headphones may also be helpful. Program a timer or alarm to sound every 5 to 10 minutes to minimize daydreaming, check on wandering focus, and provide designated break times to reset focus on the task. Attention is highly influenced by the value of the stimulus. It is far easier to attend to information that is considered to be very important or very interesting. A student who is passionate about video games may be able to focus on them for hours at a time, yet be unable to focus on his or her teacher for five minutes in the classroom when the educational material seems monotonous, repetitious, or uninteresting. ACCURATE DIAGNOSIS AND TREATMENT ARE ESSENTIAL ADHD can often be misdiagnosed. Proper diagnosis is imperative in order to effectively treat and manage the symptoms of ADHD. Symptoms of attention difficulties are found in a wide array of disorders and diseases other than ADHD, which may include but are not limited to: hearing loss, depression, anxiety, stress, behavior disorder, brain impairment, concussion, dementia, autism, seizures, auditory processing difficulties, emotional trauma, learning and memory disorders, chronic sleep deprivation, and even normal aging. As an example of the serious implications of misdiagnosis, a student who appears inattentive, due to an undiagnosed auditory processing disorder, may be incorrectly prescribed ADHD stimulant medications. In order to most accurately diagnose ADHD, a clinical interview and completion of self- report checklists are not enough. It is important to conduct a comprehensive evaluation, which includes a broad range of neuropsychological tests that measure various aspects of attention, and assist in ruling out other potential causes. Based on the findings of testing, a tailored treatment plan can be developed to address the individual’s areas of functioning that are most affected by ADHD. Depending on the age and life stage of the individual, recommendations may include academic accommodations for school and for standardized testing, work accommodations, skill training, coaching, psychotherapy, behavior therapy, and mindfulness training. A medical-psychiatric consultation for possible pharmaceutical therapy may be considered and, in many cases, may be helpful. In addition, an ADHD academic or life coach can be instrumental in teaching compensatory strategies to manage distractibility, motivation, procrastination, and organizational difficulties. Director Rosemarie Scolaro Moser, PhD, right; Sarah Friedman, PsyD, left; and Christina Zebrowski, PsyD provide neuropsychological testing, psychotherapy, and academic coaching services at the RSM Psychology Center in Princeton. Source: https://issuu.com/witherspoonmediagroup/docs/princeton_magazine_september_2019_digital_issue_

The National Register of Health Service Psychologists is proud to present the 2020 Alfred M. Wellner Lifetime Achievement Award for Clinical Excellence to Rosemarie Scolaro Moser, PhD, ABPP-RP, ABN, of the RSM Psychology Center and the Sports Concussion Center of New Jersey. This award is named in honor of the National Register’s first Executive Officer, Alfred M. Wellner, PhD, and is the highest honor bestowed on a Registrant by the National Register to commemorate numerous, significant contributions to psychology during a distinguished career. The National Register’s Awards Committee selected Dr. Moser for the Wellner Award for Clinical Excellence based on her numerous professional accomplishments and pioneering work in the field of sport neuropsychology. Among these many accomplishments, Dr. Moser created one of the premier sport concussion programs for youth in New Jersey. She has authored landmark papers and several widely cited works on concussions and mild traumatic brain sport injuries. Upon receiving the award, Dr. Moser said, “It is such a humbling experience to be recognized by my colleagues and peers and to be chosen by the National Register of Health Service Psychologists for the Alfred M. Wellner, PhD, Lifetime Achievement Award. I am truly grateful to all the patients whom I have served over the years. They have been the source and inspiration for my commitment to a clinical practice embedded in a foundation of original research, public education, and advocacy.” Dr. Moser is the Director of the RSM Psychology Center and the Sports Concussion Center of New Jersey. She received her Ph.D. in Professional Psychology, from the University of Pennsylvania and is a board-certified neuropsychologist and rehabilitation psychologist and certified school psychologist. Her publications have covered the topics of learning and memory disorders, concussion, brain injury, Alzheimer’s Disease, post-traumatic stress, psychotherapy, personality, violence, parenting techniques, alcohol/substance abuse, medical illnesses, and practice ethics. She is internationally recognized for her work in sports concussion and is the author of the highly acclaimed Ahead of the Game: The Parents’ Guide to Youth Sports Concussion (Dartmouth College Press). She has served as a scientific expert and co-author for the U.S. Centers for Disease Control and Prevention's (CDC-P) Pediatric Mild Traumatic Brain Injury Workgroup Guidelines, and as a subject matter expert and systematic review co-author for the 2017 International Consensus Conference in Sport (CIS)-Berlin and for the upcoming 2021 CIS-Paris guidelines. She has been awarded the American Psychological Association Presidential Award for Advocacy in Psychology (Karl Heiser Award), the Sports Neuropsychology Society Distinguished Career Award, and the Brain Injury Alliance of New Jersey Jill Shulman Community Pillar Award. Dr. Moser has also held leadership positions in multiple societies and associations throughout her career, is currently the president-elect of the Sports Neuropsychology Society, and has been featured in popular national media for her work. Dr. Moser has been credentialed by the National Register since 1994. This announcement will also be featured in the National Register’s Journal of Health Service Psychology. About the National Register of Health Service Psychologists The National Register of Health Service Psychologists was established in 1974 and is the largest credentialing organization for psychologists and psychology doctoral students. We are an independent nonprofit organization dedicated to improving healthcare by identifying psychologists who meet specific education and training standards, and by verifying these professionals to consumers, healthcare organizations, and regulatory bodies. The National Register currently credentials 10,000 Health Service Psychologists and has approximately 3,500 psychology doctoral student and postdoctoral trainee members of its Associate Program. For more information, visit www.nationalregister.org. For more information about this announcement, contact the National Register at 202.783.7663.

RSM Psychology and Sports Concussion Center staff present latest research at the 2020 Tenth Annual Sports Neuropsychology Society Symposium in Dallas, TX. The research focuses on the clinical criteria used to help determine when someone is recovered from concussion.

SCCNJ staff publish original research “Does Time Since Injury and Duration Matter in the Benefits of Physical Therapy Treatment for Concussion?” in the Journal of Concussion.

Distinguished Career Award Dr. Moser has been granted the SNS Distinguished Career Award is granted on an annual basis to a SNS member who is a member in good standing and has provided service, as well as made an exemplary contribution, to SNS and/or the field of sports neuropsychology over the course of his/her career.

Use Your Head to Protect Your Head The HECC Sticker On Your Helmet Will Tell You If Your Helmet Is Past Its Prime By Dr. Alan Ashare and Dr. Rosemarie Moser In youth sports, safety is a top priority, so checking your equipment is an important first step before stepping on the ice. That all-familiar sticker on your equipment lets you know that your equipment has met the standards that the Hockey Equipment Certification Council has chosen as the safest currently available for ice hockey. It may not always be clear if your equipment is certified. First, the certification of a helmet has a life span of seven years from the time it was manufactured. (It is not the date that you purchased it.) Before purchasing, check the date. The HECC sticker will have the date the helmet will be decertified. Do not remove the HECC sticker. Removal of the HECC sticker automatically decertifies the helmet. To see if your helmet or facemask is certified, check the HECC website at HECC.net. Dr. Ashare is the vice president of HECC and the co-chair of the USA Hockey Safety and Protective Equipment Committee. Dr. Moser is the director of the Sports Concussion Center of New Jersey, co-author of the U.S. CDC Pediatric Mild Traumatic Brain Injury Guidelines, and author of “Ahead of the Game: The Parents’ Guide to Youth Sports Concussion.” What The Heck Is HECC? The Hockey Equipment Certification Council is a volunteer organization whose membership includes people with a variety of interests, but who all have a common goal of improving safety and performance in ice hockey. HECC finds the best standards that are already available and then has its selected certified testing laboratory perform tests to make sure that the equipment meets the selected standard. Selecting A Better Helmet When it comes to head protection on the ice, the researchers at Virginia Tech University want you to know that all helmets are not created equally. Since 2011, they have conducted extensive research on a variety of protective head gear, including hockey helmets, with the goal of creating an unbiased rating system that will allow consumers to make an informed decision when purchasing a helmet. This work is independent of any funding or influence from helmet manufacturers. Helmets are evaluated through a series of impact tests designed to replicate a broad range of head impacts that athletes are likely to experience. These rating identify the helmets that best decrease forces to the head, which may reduce your chances of sustaining a concussion. With that stated, it’s important to note that any player in any sport can sustain a head injury with even the very best head protection. Helmets are only one piece of the equation to minimizing concussion risk. According to Virginia Tech researchers, every helmet currently on the market meets minimum safety requirements specified by standards organizations. Ratings help to identify which helmets best reduce the force delivered to the head. More stars equate to better protection, with 5 stars representing the best helmets available. Virginia Tech recommends that athletes purchase only 4 and 5 star helmets. To learn more about the research being done at Virginia Tech and to see a complete list of helmet ratings, please go to VT.edu/helmet. Source: http://touchpointmedia.uberflip.com/i/1147396-august-2019/29?m4=

Expertscape.com provides objective rankings of medical expertise locally, nationally and internationally, and guides healthcare consumers by quickly identifying doctors who are world-class experts in your specific medical disorder. Expertscape–Your first step to a Second Opinion–also identified Dr. Moser in the top 1.1% of published authors worldwide on Brain Concussion.

The Jill Schulman Community Pillar Award recognizes individuals, working in the brain injury field, who significantly contribute to the quality of life for people with brain injury and their caregivers and promote brain health through their volunteer service and support of the mission of the Brain Injury Alliance of New Jersey. Joanna Boyd of BIANJ presented the award to Dr. Moser.

From the time we learn to walk and talk, we are socialized to learn what we should and should not do. “You should always share your toys”… “You should never touch the stove”… “You should never talk to strangers.” The first “shoulds” we learn are meant to protect us and guide us, because as children we are not yet ready to make independent decisions and we are still learning about the world. Those early shoulds become internalized, ingrained, automatic recordings in our brains. This repository of shoulds creates the mini-adult who accompanies us when parents are not there to provide oversight. Our mini-adult helps keep us safe as we navigate childhood. Eventually, as we transition into adulthood, we become much less reliant on our mini-adult and are ready to make our own independent decisions and judgments. There are times we may reasonably choose not to share our possessions with someone, times we want to cook and use the stove, and times we choose to smile and greet strangers. At these points in our lives, our old internalized mini-adult is not useful, so we override it, and learn to say goodbye to it. But it is sometimes very difficult to say goodbye to an old friend. Many of us often have problems appropriately overriding the important shoulds in our lives. “I should be nice” becomes “I shouldn’t say no when my neighbor asks for a ride to work, even if it will make me late.” “I should respect my elders” becomes “I should give my older sister a loan to go on a cruise with her friends, even though I know she will never pay it back and its hard making ends meet.” “I should be a successful hard worker” becomes “I shouldn’t miss a day from work even if I have the flu.” We collect a long laundry list of shoulds as we travel through life: “I should get into the best college,” ”I should have the perfect wedding,” “I should be happy in my job,” “I should make more money,” “I should have a bigger house,” “I should have kids who get ‘A’ grades in school,” and so on. Too many shoulds weigh us down if we are not careful. Many of these shoulds make us think we are not good enough or that our lives are not good enough. We learn to not accept ourselves as human beings who try to do our best, but will never be perfect and will never make everyone happy. The unreasonable shoulds result in unhappiness, disappointment, guilt, anger, anxiety, and depression, and they are not logical. Cognitive Behavioral Therapy or “CBT” can help us reign in the shoulds and say goodbye to the mini-adult we have outgrown. What is CBT? CBT is a form of psychotherapy that works by identifying dysfunctional thought patterns (or the unreasonable shoulds) that affect how one feels and behaves. Dysfunctional thought patterns prevent the individual from living life in a productive, successful way and contribute to emotional distress, depression, anxiety, guilt, worry, and everyday stress. As a result, individuals may feel stuck, trapped, or unable to achieve their goals. COGNITIVE REFRAMING: In CBT, the therapist helps the individual see or view distressing life events and beliefs in a fresh, new light and with a new, more rational and positive perspective. It is called reframing, just as the right frame can transform the whole look of a picture. How does CBT work? CBT focuses on identifying inaccurate thinking styles and helping the individual challenge and reframe those dysfunctional thoughts. By learning to think differently and more logically, individuals can overcome their fears and find ways to cope with stress and the overwhelming demands of their daily lives. In CBT, the therapist encourages the individual to be an active participant in the treatment process by practicing new skills, learning stress reduction exercises, completing written homework to document daily events that provoke the shoulds, and trying out new behaviors in the “real world.” CBT teaches you to think out of the box, to challenge misconceptions, to acquire tools for personal change, and to feel confident moving forward. What kinds of techniques are used in CBT? Some specific techniques the therapist may use include, but are not limited to: Challenging irrational beliefs Relaxation education and training Self-monitoring Cognitive rehearsal Thought stopping Communication skills training Assertiveness skills training Social skills training Bibliotherapy Homework assignments How does one start CBT? A CBT trained therapist will first meet with you to gather information about your history and background in order to understand you better and to help you identify your personal goals. A targeted treatment plan with clearly defined objectives helps to launch the treatment. To start, therapy is usually scheduled on a weekly basis. The duration of the treatment depends on each person and her or his needs. Ultimately, in CBT, your therapist is a partner on an educational journey to help improve coping skills and emotional well-being, while equipping you with the strategies needed to meet future challenges.