Research papers that support the present guideline recommendations:
Abeare, C. A., Messa, I., Zuccato, B. G., Merker, B., & Erdodi, L. (2018). Prevalence of invalid performance on baseline testing for sport-related concussion by age and validity indicator. JAMA Neurology, 75(6), 697–703. https://doi.org/10.1001/jamaneurol.2018.0031
Anthony, C. A., & Peterson, A. R. (2015). Utilization of a text-messaging robot to assess intraday variation in concussion symptom severity scores. Clinical Journal of Sport Medicine, 25(2), 149–152. https://doi.org/10.1097/JSM.0000000000000115
Araujo, G. C., Antonini, T. N., Monahan, K., Gelfius, C., Klamar, K., Potts, M., … Bodin, D. (2014). The relationship between suboptimal effort and post-concussion symptoms in children and adolescents with mild traumatic brain injury. Clinical Neuropsychologist, 28(5), 786–801. https://doi.org/10.1080/13854046.2014.896415
Baker, D. A., Connery, A. K., Kirk, J. W., & Kirkwood, M. W. (2014). Embedded performance validity indicators within the california verbal learning test, childrens version. Clinical Neuropsychologist, 28(1), 116–127. https://doi.org/10.1080/13854046.2013.858184
Brett, B. L., & Solomon, G. S. (2017). The influence of validity criteria on Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) test–retest reliability among high school athletes. Journal of Clinical and Experimental Neuropsychology, 39(3), 286–295. https://doi.org/10.1080/13803395.2016.1224322
Brett, B. L., Smyk, N., Solomon, G., Baughman, B. C., & Schatz, P. (2016). Long-term Stability and Reliability of Baseline Cognitive Assessments in High School Athletes Using ImPACT at 1-, 2-, and 3-year Test–Retest Intervals. Archives of Clinical Neuropsychology, (August), 904–914. https://doi.org/10.1093/arclin/acw055
Brooks, B. L., Iverson, G. L., Atkins, J. E., Zafonte, R., & Berkner, P. D. (2016). Sex Differences and Self-Reported Attention Problems During Baseline Concussion Testing. Applied Neuropsychology: Child, 5(2), 119–126. https://doi.org/10.1080/21622965.2014.1003066
Brooks, B. L., Mannix, R., Maxwell, B., Zafonte, R., Berkner, P. D., & Iverson, G. L. (2016). Multiple Past Concussions in High School Football Players. American Journal of Sports Medicine, 44(12), 3243–3251. https://doi.org/10.1177/0363546516655095
Brooks, B. L., McKay, C. D., Mrazik, M., Barlow, K. M., Meeuwisse, W. H., & Emery, C. A. (2013). Subjective, but not Objective, Lingering Effects of Multiple Past Concussions in Adolescents. Journal of Neurotrauma, 30(17), 1469–1475. https://doi.org/10.1089/neu.2012.2720
Brooks, M. A., Snedden, T. R., Mixis, B., Hetzel, S., & McGuine, T. A. (2017). Establishing baseline normative values for the child sport concussion assessment tool. JAMA Pediatrics, 171(7), 670–677. https://doi.org/10.1001/jamapediatrics.2017.0592
Chin, E. Y., Nelson, L. D., Barr, W. B., McCrory, P., & McCrea, M. A. (2016). Reliability and validity of the sport concussion assessment tool-3 (SCAT3) in high school and collegiate athletes. American Journal of Sports Medicine, 44(9), 2276–2285. https://doi.org/10.1177/0363546516648141
Collings, L. J., Cook, N. E., Porter, S., Kusch, C., Sun, J., Virji-Babul, N., … Panenka, W. J. (2017). Attention-deficit/hyperactivity disorder is associated with baseline child sport concussion assessment tool third edition scores in child hockey players. Brain Injury, 31(11), 1479–1485. https://doi.org/10.1080/02699052.2017.1377351
Cook, N. E., Huang, D. S., Silverberg, N. D., Brooks, B. L., Maxwell, B., Zafonte, R., … Iverson, G. L. (2017). Baseline cognitive test performance and concussion-like symptoms among adolescent athletes with ADHD: examining differences based on medication use. Clinical Neuropsychologist, 31(8), 1341–1352. https://doi.org/10.1080/13854046.2017.1317031
Cook, N. E., Kelshaw, P. M., Caswell, S. V., & Iverson, G. L. (2019). Children with Attention-Deficit/Hyperactivity Disorder Perform Differently on Pediatric Concussion Assessment. Journal of Pediatrics, 214, 168-174.e1. https://doi.org/10.1016/j.jpeds.2019.07.048
Covassin, T., Crutcher, B., & Wallace, J. (2013). Does a 20 minute cognitive task increase concussion symptoms in concussed athletes? Brain Injury, 27(13–14), 1589–1594. https://doi.org/10.3109/02699052.2013.823656
Custer, A., Sufrinko, A., Elbin, R. J., Covassin, T., Collins, M., & Kontos, A. (2016). High baseline postconcussion symptom scores and concussion outcomes in athletes. Journal of Athletic Training, 51(2), 136–141. https://doi.org/10.4085/1062-6050-51.2.12
Davis, G. A., Purcell, L., Schneider, K. J., Yeates, K. O., Gioia, G. A., Anderson, V., … Kutcher, J. S. (2017). The Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5): Background and rationale. British Journal of Sports Medicine, 51(11), 859–861. https://doi.org/10.1136/bjsports-2017-097492
Elbin, R. J., Kontos, A. P., Kegel, N., Johnson, E., Burkhart, S., & Schatz, P. (2013). Individual and combined effects of LD and ADHD on computerized neurocognitive concussion test performance: Evidence for separate norms. Archives of Clinical Neuropsychology, 28(5), 476–484. https://doi.org/10.1093/arclin/act024
Gardner, R. M., Yengo-Kahn, A., Bonfield, C. M., & Solomon, G. S. (2017). Comparison of baseline and post-concussion ImPACT test scores in young athletes with stimulant-treated and untreated ADHD. Physician and Sportsmedicine, 45(1), 1–10. https://doi.org/10.1080/00913847.2017.1248221
Gidley Larson, J. C., Flaro, L., Peterson, R. L., Connery, A. K., Baker, D. A., & Kirkwood, M. W. (2015). The medical symptom validity test measures effort not ability in children: A comparison between mild TBI and fetal alcohol spectrum disorder samples. Archives of Clinical Neuropsychology, 30(3), 192–199. https://doi.org/10.1093/arclin/acv012
Glaviano, N. R., Benson, S., Goodkin, H. P., Broshek, D. K., & Saliba, S. (2015). Baseline SCAT2 Assessment of Healthy Youth Student-Athletes: Preliminary Evidence for the Use of the Child-SCAT3 in Children Younger Than 13 Years. Clinical Journal of Sport Medicine, 25(4), 373–379. https://doi.org/10.1097/JSM.0000000000000154
Gorman, M., Hecht, S., Samborski, A., Lunos, S., Elias, S., & Stovitz, S. D. (2017). SCAT3 assessment of non-head injured and head injured athletes competing in a large international youth soccer tournament. Applied Neuropsychology: Child, 6(4), 364–368. https://doi.org/10.1080/21622965.2016.1210011
Green, C. M., Kirk, J. W., Connery, A. K., Baker, D. A., & Kirkwood, M. W. (2014). The use of the Rey 15-Item Test and recognition trial to evaluate noncredible effort after pediatric mild traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 36(3), 261–267. https://doi.org/10.1080/13803395.2013.879096
Haider, M. N., Leddy, J. J., Pavlesen, S., Kluczynski, M., Baker, J. G., Miecznikowski, J. C., & Willer, B. S. (2018). A systematic review of criteria used to define recovery from sport-related concussion in youth athletes. British Journal of Sports Medicine, 52(18), 1179–1190. https://doi.org/10.1136/bjsports-2016-096551
Higgins, K. L., Denney, R. L., & Maerlender, A. (2017). Sandbagging on the immediate post-concussion assessment and cognitive testing (impact) in a high school athlete population. Archives of Clinical Neuropsychology, 32(3), 259–266. https://doi.org/10.1093/arclin/acw108
Iverson, G. L., Silverberg, N. D., Mannix, R., Maxwell, B. A., Atkins, J. E., Zafonte, R., & Berkner, P. D. (2015). Factors associated with concussion-like symptom reporting in high school athletes. JAMA Pediatrics, 169(12), 1132–1140. https://doi.org/10.1001/jamapediatrics.2015.2374
Kirk, J. W., Hutaff-Lee, C. F., Connery, A. K., Baker, D. A., & Kirkwood, M. W. (2014). The Relationship Between the Self-Report BASC-2 Validity Indicators and Performance Validity Test Failure After Pediatric Mild Traumatic Brain Injury. Assessment, 21(5), 562–569. https://doi.org/10.1177/1073191114520626
Kirkwood, M. W., Peterson, R. L., Connery, A. K., Baker, D. A., & Grubenhoff, J. A. (2014). Postconcussive Symptom Exaggeration After Pediatric Mild Traumatic Brain Injury. Pediatrics, 133(4), 643–650. https://doi.org/10.1542/peds.2013-3195
Kuhn, A. W., & Solomon, G. S. (2014). Supervision and computerized neurocognitive baseline test performance in high school athletes: An initial investigation. Journal of Athletic Training, 49(6), 800–805. https://doi.org/10.4085/1062-6050-49.3.66
Lichtenstein, J. D., Moser, R. S., & Schatz, P. (2014). Age and test setting affect the prevalence of invalid baseline scores on neurocognitive tests. American Journal of Sports Medicine, 42(2), 479–484. https://doi.org/10.1177/0363546513509225
Liller, K. D., Morris, B., Fillion, J., Yang, Y., & Bubu, O. M. (2017). Analysis of baseline computerized neurocognitive testing results among 5-11-year-old male and female children playing sports in recreational leagues in Florida. International Journal of Environmental Research and Public Health, 14(9). https://doi.org/10.3390/ijerph14091028
Lovell, M. R., & Solomon, G. S. (2013). Neurocognitive test performance and symptom reporting in cheerleaders with concussions. Journal of Pediatrics, 163(4), 1192–1195.e1. https://doi.org/10.1016/j.jpeds.2013.05.061
MacDonald, J., & Duerson, D. (2015). Reliability of a Computerized Neurocognitive Test in Baseline Concussion Testing of High School Athletes. Clinical Journal of Sport Medicine, 25(4), 367–372. https://doi.org/10.1097/JSM.0000000000000139
Mannix, R., Iverson, G. L., Maxwell, B., Atkins, J. E., Zafonte, R., & Berkner, P. D. (2014). Multiple prior concussions are associated with symptoms in high school athletes. Annals of Clinical and Translational Neurology, 1(6), 433–438. https://doi.org/10.1002/acn3.70
McGrath, N., Dinn, W. M., Collins, M. W., Lovell, M. R., Elbin, R. J., & Kontos, A. P. (2013). Post-exertion neurocognitive test failure among student-athletes following concussion. Brain Injury, 27(1), 103–113. https://doi.org/10.3109/02699052.2012.729282
McKay, C. D., Schneider, K. J., Brooks, B. L., Mrazik, M., & Emery, C. A. (2014). Baseline Evaluation in Youth Ice Hockey Players: Comparing Methods for Documenting Prior Concussions and Attention or Learning Disorders. Journal of Orthopaedic & Sports Physical Therapy, 44(5), 329–335. https://doi.org/10.2519/jospt.2014.5053
Moran, R. N., & Covassin, T. (2018). King-Devick test normative reference values and internal consistency in youth football and soccer athletes. Scandinavian Journal of Medicine and Science in Sports, 28(12), 2686–2690. https://doi.org/10.1111/sms.13286
Moser, R. S., Olek, L., & Schatz, P. (2019). Gender Differences in Symptom Reporting on Baseline Sport Concussion Testing Across the Youth Age Span. Archives of Clinical Neuropsychology : The Official Journal of the National Academy of Neuropsychologists, 34(1), 50–59. https://doi.org/10.1093/arclin/acy007
Moser, R. S., Schatz, P., Grosner, E., & Kollias, K. (2017). One year test–retest reliability of neurocognitive baseline scores in 10- to 12-year olds. Applied Neuropsychology: Child, 6(2), 166–171. https://doi.org/10.1080/21622965.2016.1138310
Nelson, L. D., Laroche, A. A., Pfaller, A. Y., Lerner, E. B., Hammeke, T. A., Randolph, C., … McCrea, M. A. (2015). Prospective, head-to-head study of three computerized neurocognitive assessment tools (CNTs): Reliability and validity for the assessment of sport-related concussion. Journal of the International Neuropsychological Society, 22(1), 24–37. https://doi.org/10.1017/S1355617715001101
Nelson, L. D., Loman, M. M., LaRoche, A. A., Furger, R. E., & McCrea, M. A. (2017). Baseline Performance and Psychometric Properties of the Child Sport Concussion Assessment Tool 3 (Child-SCAT3) in 5- to 13-year-old Athletes. Clinical Journal of Sport Medicine, 27(4), 381–387. https://doi.org/10.1097/JSM.0000000000000369
Nelson, L. D., Pfaller, A. Y., Rein, L. E., & McCrea, M. A. (2015). Rates and Predictors of Invalid Baseline Test Performance in High School and Collegiate Athletes for 3 Computerized Neurocognitive Tests: NAM,Axon Sports, and ImPACT. American Journal of Sports Medicine, 43(8), 2018–2026. https://doi.org/10.1177/0363546515587714
Newcomer, R. R., & Perna, F. M. (2003). Adolescent Athletes. Journal of Athletic Training, 38(2), 163–166.
Ott, S., Schatz, P., Solomon, G., & Ryan, J. J. (2014). Neurocognitive performance and symptom profiles of spanish-speaking hispanic athletes on the impact test. Archives of Clinical Neuropsychology, 29(2), 152–163. https://doi.org/10.1093/arclin/act091
Pawlukiewicz, A., Yengo-Kahn, A. M., & Solomon, G. (2017). The effect of pretest exercise on baseline computerized neurocognitive test scores. Orthopaedic Journal of Sports Medicine, 5(10), 1–6. https://doi.org/10.1177/2325967117734496
Peltonen, K., Vartiainen, M., Laitala-Leinonen, T., Koskinen, S., Luoto, T., Pertab, J., & Hokkanen, L. (2019). Adolescent athletes with learning disability display atypical maturational trajectories on concussion baseline testing: Implications based on a Finnish sample. Child Neuropsychology, 25(3), 336–351. https://doi.org/10.1080/09297049.2018.1474865
Porter, S., Smith-Forrester, J., Alhajri, N., Kusch, C., Sun, J., Barrable, B., … Virji-Babul, N. (2017). The Child Sport Concussion Assessment Tool (Child SCAT3): Normative values and correspondence between child and parent symptom scores in male child athletes. BMJ Open Sport and Exercise Medicine, 3(1), 1–6. https://doi.org/10.1136/bmjsem-2015-000029
Reesman, J., Pineda, J., Carver, J., Brice, P. J., Andrew Zabel, T., & Schatz, P. (2016). Utility of the ImPACT test with deaf adolescents. Clinical Neuropsychologist, 30(2), 318–327. https://doi.org/10.1080/13854046.2016.1142613
Reynolds, E., Fazio, V. C., Sandel, N., Schatz, P., & Henry, L. C. (2016). Cognitive Development and the Immediate Postconcussion Assessment and Cognitive Testing: A Case for Separate Norms in Preadolescents. Applied Neuropsychology: Child, 5(4), 283–293. https://doi.org/10.1080/21622965.2015.1057637
Rieger, B. P., Lewandowski, L. J., Callahan, J. M., Spenceley, L., Truckenmiller, A., Gathje, R., & Miller, L. A. (2013). A prospective study of symptoms and neurocognitive outcomes in youth with concussion vs orthopaedic injuries. Brain Injury, 27(2), 169–178. https://doi.org/10.3109/02699052.2012.729290
Sandel, N. K., Worts, P. R., Burkhart, S., & Henry, L. (2018). Comparison of baseline ImPACT performance in amateur motocross riders to football and basketball athletes. Brain Injury, 32(4), 493–497. https://doi.org/10.1080/02699052.2018.1429020
Schatz, P., & Robertshaw, S. (2014). Comparing post-concussive neurocognitive test data to normative data presents risks for under-classifying “above average” athletes. Archives of Clinical Neuropsychology, 29(7), 625–632. https://doi.org/10.1093/arclin/acu041
Schatz, P., Kelley, T., Ott, S. D., Solomon, G. S., Elbin, R. J., Higgins, K., & Moser, R. S. (2014). Utility of repeated assessment after invalid baseline neurocognitive test performance. Journal of Athletic Training, 49(5), 659–664. https://doi.org/10.4085/1062-6050-49.3.37
Snedden, T. R., Brooks, M. A., Hetzel, S., & McGuine, T. (2017). Normative Values of the Sport Concussion Assessment Tool 3 (SCAT3) in High School Athletes. Clinical Journal of Sport Medicine, 27(5), 462–467. https://doi.org/http://dx.doi.org/10.1097/jsm.0000000000000389
Snyder, A. R., & Bauer, R. M. (2014). A normative study of the sport concussion assessment tool (SCAT2) in children and adolescents. Clinical Neuropsychologist, 28(7), 1091–1103. https://doi.org/10.1080/13854046.2014.952667
Tomczyk, C. P., Mormile, M., Wittenberg, M. S., Langdon, J. L., & Hunt, T. N. (2018). An examination of adolescent athletes and nonathletes on baseline neuropsychological test scores. Journal of Athletic Training, 53(4), 404–409. https://doi.org/10.4085/1062-6050-84-17
Tsushima, W. T., Shirakawa, N., & Geling, O. (2013). Neurocognitive functioning and symptom reporting of high school athletes following a single concussion. Applied Neuropsychology: Child, 2(1), 13–16. https://doi.org/10.1080/09084282.2011.643967
Tsushima, W. T., Siu, A. M., Pearce, A. M., Zhang, G., & Oshiro, R. S. (2016). Two-year Test-Retest Reliability of ImPACT in High School Athletes. Archives of Clinical Neuropsychology, 31(1), 105–111. https://doi.org/10.1093/arclin/acv066
Tsushima, W. T., Tsushima, V. G., Oshiro, R. O., & Murata, N. M. (2017). Role of Native Language in Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) of Youth Athletes. Archives of Clinical Neuropsychology, 32(4), 450–455. https://doi.org/10.1093/arclin/acx025
Vaughan, C. G., Gerst, E. H., Sady, M. D., Newman, J. B., & Gioia, G. A. (2014). The relation between testing environment and baseline performance in child and adolescent concussion assessment. American Journal of Sports Medicine, 42(7), 1716–1723. https://doi.org/10.1177/0363546514531732
Vernau, B. T., Grady, M. F., Goodman, A., Wiebe, D. J., Basta, L., Park, Y., … Master, C. L. (2015). Oculomotor and neurocognitive assessment of youth ice hockey players: Baseline associations and observations after concussion. Developmental Neuropsychology, 40(1), 7–11. https://doi.org/10.1080/87565641.2014.971955
Womble, M. N., Reynolds, E., Schatz, P., Shah, K. M., & Kontos, A. P. (2016). Test-Retest reliability of computerized neurocognitive testing in youth ice hockey players. Archives of Clinical Neuropsychology, 31(4), 305–312. https://doi.org/10.1093/arclin/acw011
Yengo-Kahn, A. M., & Solomon, G. (2015). Are psychotropic medications associated with differences in baseline neurocognitive assessment scores for young athletes? A pilot study. Physician and Sportsmedicine, 43(3), 227–235. https://doi.org/10.1080/00913847.2015.1071638
Zalneraitis, B. H., Yengo-Kahn, A. M., Pawlukiewicz, A. J., & Solomon, G. S. (2017). Self-reported history of seizure and baseline neurocognitive test performance in student-athletes: an initial investigation. Physician and Sportsmedicine, 45(4), 470–474. https://doi.org/10.1080/00913847.2017.1372035
Date of last update: November 16, 2019