Impact of Factors that Affect Reading Skill Level on King–Devick Baseline Performance Time


The King–Devick (K–D) test is often used as part of a multimodal assessment to screen for sport-related concussion. However, the test involves reading numbers, and little is known about variation in baseline performance on the K–D by reading skill level. We conducted a cross-sectional study analyzing data from the Concussion Assessment, Research and Education (CARE) Consortium to assess differences in baseline performance on the K–D associated with factors that impact reading skill level (learning disorder [LD] and primary home language other than English [PHLOTE]), while controlling for covariates (gender, type of sport, attentional issues, history of concussion and modality of administration). We had a sample of 2311 student-athletes (47% female), and multivariate regression indicated an average K–D performance time of 40.4 s. Presence of LD was associated with a 3.3 s slower K–D time (95% CI 1.9–4.7, p < 0.001), and PHLOTE was associated with a 2.6 s slower K–D time (95% CI 1.2–4.0, p < 0.001), after controlling for other covariates. These results suggest caution in the use of normative data with the K–D. Future studies should explore the impact of factors associated with reading skill level on sensitivity of the K–D in detecting concussion.

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Fig. 1





Learning disorder


Primary home language other than English


Confidence interval

CARE study:

Concussion Assessment, Research and Education


Department of Defense


National Collegiate Athletic Association


Human Research Protection Office


Attention deficit hyperactivity disorder


Standard deviation


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This publication was made possible in part with support from the Grand Alliance Concussion Assessment, Research, and Education (CARE) Consortium, funded, by the National Collegiate Athletic Association (NCAA) and the Department of Defense (DOD). The U.S. Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick, MD 21702-5014 is the awarding and administering acquisition office. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Psychological Health and Traumatic Brain Injury Program under Award No. W81XWH-14-2- 0151. Opinions, interpretations, conclusions and recommendations are those of the author(s) and are not necessarily endorsed by the Department of Defense or the NCAA.

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Correspondence to S. P. D. Chrisman.

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Associate Editor Stefan Duma oversaw the review of this article.

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Chrisman, S.P.D., Harmon, K.G., Schmidt, J.D. et al. Impact of Factors that Affect Reading Skill Level on King–Devick Baseline Performance Time. Ann Biomed Eng 47, 2122–2127 (2019).

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  • Concussion
  • Mild traumatic brain injury
  • Learning disorder
  • Oculomotor
  • Saccades
  • Sport
  • Screening