AAI is a muscular instability in the neck that affects up to 15% of individuals with Down syndrome, exposing them to possible injury if they participate in activities that hyper-extend or hyper-flex the neck or upper spine.
AAI is identified through the medical examination required for athlete participation.
The medical form procedures include an assessment of symptoms of adverse neurological effect that replaces the x-ray examination requirement.
If the athlete does have symptoms then he or she may only participate if the athlete receives a thorough neurological evaluation from a physician qualified to state that the cause of those symptoms will not result in additional risk of neurological injury due to sports participation and certifies that the athlete may participate. The athlete of the parent or guardian of a minor athlete signs an informed consent that acknowledges they have been informed of the findings and determinations of the physician.