WEST POINT, NY – In support of the Department of Defense and the Army’s Warfighter Brain Health Initiative, members of the U.S. Army Office of the Surgeon General (OTSG) spent two days, Nov. 4-5, testing the U.S. Army’s Core Cognitive Assessments . First Class Cadets of the Academy.

The cognitive assessment program, which began in 2007 primarily as a pre-deployment and injury-focused tool, now monitors all initial, enlisted and future military members as a measure to protect brain health throughout their military careers.

The Initial Training (IET) Cognitive Monitoring Program (CMP) was launched in July at Fort Sill, Oklahoma, and then continued at other IET stations within the Army, Navy, Marine Corps, ROTC programs and other military academies.

Dr. Steven Porter, chief of the Neurocognitive Assessment Service at the U.S. Army OTSG, pointed out that one of the main aspects of these initial assessments in monitoring the brain health of service members is to ensure that if they are involved in a brain-altering incident at any point in their career and results in a cognitive change, physicians or clinicians will have the ability to identify it early.

“We can intervene early, which allows us to provide whatever services may be needed, even if it’s just taking the knee for 24 to 48 hours, because the brain will spontaneously recover,” Porter explained.

Porter said this is not a new concept, as they have been conducting baseline assessments since 2007 at the height of the Global War on Terrorism, but the brain health initiative is making it more defined now.

“Our military members have been exposed to explosives (IEDs) and suffered concussions. Moderate and severe concussions are much more visible, but mild concussions tend not to be visible,” Porter said. “People were hiding them more and unfortunately not seeking care.

“The science was in its infancy then … now, if you have a suspected brain injury, we test you right away and then compare you to your baseline,” Porter added. “That will tell us a few things. First, it will tell us the extent of your injury, but most importantly, it will help us track your recovery.”

Porter said the ramifications of a concussion, depending on the severity, can lead to physiological symptoms that include mood changes, but also problems with balance and cognitive processing, which is the speed at which you process information.

“That’s one of the last things that gets resolved without a baseline to know where you were before the injury,” Porter said. “Previously, it was very difficult for providers to understand when you were back (to normal) because you could be physically recovered with no dizziness, no nausea, no vomiting, no obvious physical symptoms, but your processing still couldn’t be back to normal. “

Col. Jama VanHorne-Sealy, director of the US Army’s Occupational Health Directorate, said the overall initiative focuses on the importance of optimizing both the physical and cognitive performance of soldiers to improve and maintain force readiness.

“Taking care of our Soldiers is and always will be our top priority for the Army,” VanHorne-Sealy said. “In 2007, we began performing basic cognitive assessments as part of a program to understand brain damage after IED exposure. The evaluation was part of a pre-implementation process.

“In response to increased understanding of the risks to brain health,” she added, “the program has evolved into a cognitive monitoring program that will span a soldier’s entire military career.”

As the Firstie cadets go through the basic process, the intention will be to collect the cognitive baseline of each of them early in their military career to identify any neurocognitive changes later to help monitor any recovery they may have needed in a post-traumatic brain injury. (TBI) diagnosis.

“Using baseline data, we can compare future re-evaluations to determine if an evaluation or medical care is needed,” explained VanHorne-Sealy. “However, based on the soldier’s occupational specialty (or branch) risk, they will be reevaluated between one and three years into their career.”

Porter reiterated that whether it’s in training or deployment, it depends on the MOS or the branch, who has the highest risk of exposure to “blast overpressure” from explosions will receive reassessments more frequently.

“We can monitor them and if there are changes, we have to intervene early,” Porter said.

Porter defined that basic testing involves 10 modules of cognition, which are the 10 areas of your brain that process information.

“How fast does your brain process information?” Porter said. “They (cadets) take a test that allows us to look at the 10 domains or 10 domains of cognitive functioning to see where they are today.”

The point of the process is when they come back for a reassessment, it’s to see if they’re at the same cognitive level as they were previously tested.

“We’ll know through this test if your change is greater than expected,” Porter said. “It’s a screening tool that tells us, ‘OK, we need to take a closer look.’ If so, then we do a clinical interview, clinical assessment and further follow-up tests if necessary to see what might be causing the clinical change.”

As for testing, it depends on the modality, but it can involve a stimulus appearing on a computer screen and you press the mouse for reaction time. Some of the other assessment modules include short-term memory and simple math problems.

For Porter, he was a neurocognitive clinician for 24 years, the first 20 in the Navy and then less than two years with the U.S. Army Special Operations Command before his current role. He determines that his role is to bring service members back into the field and to be as competent as possible.

Being proactive in the monitoring process early in a career is a relatively new concept, but early intervention can change the dynamics of a soldier’s career, which will “keep them safe and on mission,” Porter said.

Porter considers his job with the Army OTSG an amazing experience to be part of the lead agency in cognitive monitoring to positively change the lives and careers of many Soldiers.

“It’s one of the most rewarding things I’ve done professionally,” Porter proclaimed. “I spent 20 years in the Navy as a neuropsychologist and was involved in and led the development of the new tests we use today. Overall, knowing that we can help our service members sooner makes the 60-hour work week that much more worthwhile.”