scholarly journals Preseason Baseline Neurocognitive Performances and Symptom Reporting on ImPACT®: A Comparison of Adolescent Student-Athletes Tested in Spanish and English

2020 ◽  
Author(s):  
Justin E. Karr ◽  
Mauricio A. Garcia-Barrera ◽  
Jacqueline M. Marsh ◽  
Bruce Maxwell ◽  
Paul D. Berkner ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Student Athletes ◽  
Symptom Reporting ◽  
Group Differences ◽  
Language Group ◽  
Motor Speed ◽  
Language Groups ◽  
Baseline Testing ◽  
Composite Scores ◽  
The Impact

Abstract Context: Student-athletes are commonly administered the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT®) battery at preseason baseline and post concussion. The ImPACT® is available in many different languages, but few studies have examined differences in cognitive performances and symptom ratings based on language of administration. Objective: This study examined differences on ImPACT® neurocognitive composites and symptom reporting at preseason baseline testing between student-athletes completing ImPACT® in Spanish versus English. Design: Cross-sectional study. Setting: Preseason baseline testing for a high school concussion management program in STATE-XXX. Patients of Other Participants: Adolescent student-athletes completing testing in Spanish (n=169) and English (n=169) were matched on age, gender, and health/academic history. Language groups were compared on each outcome for the full sample and for gender-stratified subsamples. Main Outcome Measure(s): Neurocognitive composite scores and individual and total symptom severity ratings from the ImPACT® battery. Results: Athletes tested in Spanish had lower neurocognitive performances on two of five composite scores (i.e., Visual Motor Speed, p<.001, d=.51; Reaction Time: p=.004, d=.33) and reported greater symptom severity (p<.001, r=.21). When analyses were stratified by gender, similar Visual Motor Speed differences were observed between language groups among boys (p=.001, d=.49) and girls (p=.001, d=0.49), whereas Reaction Time showed a larger group difference for boys (p=.012, d=.42) than girls (p=.128, d=.21). Language group differences in symptom reporting were similar for boys (p=.003, r=.22) and girls (p=.008, r=.21), with more frequent endorsement of physical and affective symptoms by athletes tested in Spanish. Conclusions: Language group differences in total symptom severity were small (r=.21), and language group differences in neurocognitive performances were small-to-medium (d=.05–.51). Compared to previous studies comparing athletes tested in Spanish and English on ImPACT®, smaller effects were observed in the current study, which may be attributable to close matching on variables related to neurocognitive performances and symptom reporting. Key points:

scholarly journals A-134 A Comparison Between English-Speaking and Mandarin-Speaking Adolescent Student Athletes on Baseline Preseason ImPACT® Neurocognitive Performances and Symptom Reporting

2020 ◽  
Vol 35 (6) ◽  
pp. 927-927
Author(s):  
Iverson G ◽  
Karr J ◽  
Hong Y ◽  
Yang C ◽  
Maxwell B ◽  
...  
Keyword(s):  
Student Athletes ◽  
Physical Symptoms ◽  
Symptom Reporting ◽  
Group Differences ◽  
Motor Speed ◽  
Academic History ◽  
Language Groups ◽  
English Speaking ◽  
Adolescent Student ◽  
Composite Scores

Abstract Objective Student athletes commonly complete baseline preseason assessments of neurocognitive performances and symptom reporting using ImPACT®. Some past researchers have examined differences in performances and symptoms based on language of administration and racial/ethnic identity. This study examines differences between Mandarin-speaking and English-speaking student athletes on ImPACT® at preseason assessments. Method Participants included 252 adolescent student athletes who completed preseason baseline ImPACT® testing in Mandarin and 252 participants who completed testing in English, matched on age, gender, and health and academic history. These groups were compared on neurocognitive composite scores and symptom ratings. Results Mandarin-speaking athletes performed modestly better on one of five neurocognitive composite scores (Visual Motor Speed, p < .001, d = .37). Language groups did not differ in total symptom severity, but Mandarin-speaking boys endorsed multiple physical symptoms at higher rates than English-speaking boys. Conclusions These results suggest that the current ImPACT® neurocognitive normative data are reasonably appropriate for use with Mandarin-speaking adolescents. When back translated, a few Mandarin-language symptoms were not semantically equivalent to their corresponding English-language symptoms, but no group differences were observed for these symptoms. Modest language group differences were observed in physical symptom reporting, more so in boys than girls. Individuals of Asian descent are more likely to express their mental health concerns in somatic terms, and greater physical symptoms in Mandarin-speaking boys could correspond to an expression of psychological distress. Clinicians should be mindful of psychological functioning at baseline testing and post-concussion evaluations because students who do not identify with the dominant culture of their sporting environment might experience acculturative stress.

scholarly journals A-142 Examining the Impact of the Recent New Dot Counting Test Cut-Off Score in Bilingualism and Traumatic Brain Injury Survivors

2020 ◽  
Vol 35 (6) ◽  
pp. 935-935
Author(s):  
Graub N ◽  
Lopez-Hernandez D ◽  
Litvin P ◽  
Rugh-Fraser R ◽  
Rad H ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
First Language ◽  
The Other ◽  
Group Differences ◽  
Failure Rates ◽  
Language Groups ◽  
English Second Language ◽  
Chi Squared ◽  
The Impact

Abstract Objective McCaul et al. (2018) recently revised the Dot Counting Test (DCT) cut-off score from ≥17 to 13.80; we evaluated the new cut-off in monolingual and bilingual traumatic brain injury survivors (TBIS) and healthy comparison participants (HCP). Method The sample consisted of 43 acute TBI [ATBI; 23 English monolinguals (EM); 11 English first language bilinguals (EFLB); and 9 English second language bilinguals (ESLB)]; 30 chronic TBI (CTBI; 13 EM; 9 EFLB; 8 ESLB), and 56 HCP (23 EM; 11 EFLB; 22 ESLB). Results An ANCOVA, controlling for age and education, revealed an interaction where ATBI-EFLB had higher E-scores than the other groups and the CTBI-EFLB had lower E-scores than the other groups. Both the conventional and proposed new cut-off (PNC) scores had different failure rates in ATBI (conventional cut-off: 9%; PNC: 28%), CTBI (conventional cut-off: 10%; PNC: 20%), and HCP (conventional cut-off: 11%; PNC: 13%). For language groups, EM (conventional cut-off: 14%; PNC: 22%), EFLB (conventional cut-off: 10%; PNC: 26%), and ESLB (conventional cut-off: 5%; PNC: 10%) demonstrated different failure rates across cut-off scores. Group differences were found with McCaul et al. (2018) cut-off, but not the conventional cut-off score. Also, chi-squared analysis revealed ATBI EFLB and EM had greater failure rates than ATBI ESLB. Conclusion Unfortunately, the new DCT cut-off score resulted in greater failure rates in TBIS. Furthermore, ATBI EM and EFLB were impacted more by the new cut offs than ATBI ESLB who learned English later in life, although the reason for this finding is unclear and requires additional study.

scholarly journals Age of First Exposure to Contact Sports and Neurocognitive Performance in U.S. Service Academy Athletes

2019 ◽  
Vol 34 (5) ◽  
pp. 753-753
Author(s):  
J B Caccese ◽  
G L Iverson ◽  
K L Cameron ◽  
M N Houston ◽  
G T McGinty ◽  
...  
Keyword(s):  
Reaction Time ◽  
Symptom Severity ◽  
Sports Participation ◽  
Ice Hockey ◽  
Motor Speed ◽  
Neurocognitive Performance ◽  
Contact Sports ◽  
Visual Motor ◽  
Service Academy ◽  
The Impact

Abstract Purpose To examine the association between estimated age of first exposure (eAFE) to contact sports and neurocognitive performance and symptom ratings in collegiate U.S. Military Service Academy athletes. We hypothesized that contact-sports participation before the age of 12 would not be associated with worse neuropsychological test performance or greater symptom reporting. Methods Male cadets (N=891) who participated in contact sports [i.e., in lacrosse (n=211), wrestling (n=170), ice hockey (n=81), soccer (n=119), rugby (n=10)], or non-contact sports (n=298), completed the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) test before the season. Generalized linear modeling was used to predict each cognitive domain score and the symptom severity score. Predictor variables were entered in the following order: group (contact vs. non-contact), eAFE (eAFE<12 vs. eAFE≥12), group-by-eAFE, and covariates for learning accommodation status, concussion history, and age. Results The group-by-eAFE interaction was not significant for any of the ImPACT composite scores (Verbal Memory, Wald Χ2=.073, p=.788; Visual Memory, Wald Χ2=2.71, p=.100; Visual Motor Speed, Wald Χ2=.078, p=.780; Reaction Time, Wald Χ2=.003, p=.955; Symptom Severity, Wald Χ2=2.87, p=.090). Learning accommodation history was associated with lower scores on Visual Motor Speed (Χ2=6.19, p=.013, B=-2.97). Older age was associated with faster reaction time (Χ2=4.40, p=.036, B=-.006) and lesser symptom severity (Χ2=5.55, p=.019, B=-.068). No other parameters were significant. Conclusion We observed no association between eAFE, contact-sport participation, cognitive functioning, or subjectively-experienced symptoms in this cohort. Earlier eAFE to RHI is not related to worse neurocognitive performance or greater subjectively-experienced symptoms in collegiate student-athletes enrolled in military academies.

scholarly journals Exposure to Serial Post-Concussion Neurocognitive Testing Does not Affect Future “Updated” Baseline Neurocognitive Performance in Adolescent Athletes

2019 ◽  
Vol 34 (5) ◽  
pp. 757-757
Author(s):  
S O'Connor ◽  
T Dean ◽  
R J Elbin ◽  
P Schatz
Keyword(s):  
Dose Response ◽  
Visual Memory ◽  
Impact Testing ◽  
Motor Speed ◽  
Neurocognitive Testing ◽  
Symptom Scores ◽  
Baseline Testing ◽  
Visual Motor ◽  
Response Groups ◽  
The Impact

Abstract Purpose We investigated a dose response for serial post-concussion neurocognitive testing exposure on updated post-concussion baseline testing performance. Methods Athletes (13-18 yrs) that completed two, valid baseline neurocognitive testing (ImPACT) sessions approximately 1-3 years apart participated in this study. A sub-sample of athletes that sustained a SRC between baseline sessions were categorized into dose-response groups based on the number of serial, post-concussion neurocognitive tests completed following SRC: ONE (n=76), TWO (n=99), and THREE OR MORE (n=111). Athletes that did not sustain a SRC comprised the ZERO group (n=289). Change scores between the first to the second baseline were calculated for the ImPACT Composite and Symptom Scores and compared between the dose-response groups and controls with 5 ANOVAs, with a Bonferroni-corrected p-value of (p<.01). Baseline testing was administered using ImPACT stimuli within the “Baseline” administration, and all post-concussion ImPACT testing was administered using alternate-form associated with that specific post-injury assessment (Post-Injury1, Post-Injury2, etc). Results ANOVAs revealed no effect of number of post-concussion assessments (0, 1, 2, or 3+) on magnitude of the change between first and final baselines, for Verbal Memory (p=.08), Visual Memory (p=.96), Visual Motor Speed (p=.47), Reaction Time (p=.91), or Total Symptom Scores (p=.86). Conclusion Repeated exposure to neurocognitive testing has revealed improvements in Visual Motor Speed among normal controls, across test-retest intervals of 1-month, 1-year, and 2-years. However, in this study, exposure to post-concussion, serial neurocognitive testing had no effect on future performance on post-concussion baseline neurocognitive testing.

Preseason Symptom Reporting and Cognition in Middle School Athletes with Past Concussions

2022 ◽  
Author(s):  
Grant L. Iverson ◽  
Paul D. Berkner ◽  
Ross Zafonte ◽  
Bruce Maxwell ◽  
Douglas P. Terry
Keyword(s):  
Visual Memory ◽  
Cognitive Testing ◽  
Symptom Reporting ◽  
Symptom Scale ◽  
Health History ◽  
School Sports ◽  
History Of ◽  
Concussion History ◽  
Composite Scores ◽  
The Impact

AbstractThis study examined the association between past concussions and current preseason symptom reporting and cognitive performance in 9,257 youth ages 11–13. Participants completed neurocognitive testing prior to participating in a school sports between 2009 and 2019. We stratified the sample by gender and number of prior concussions and assessed group differences on the Post-Concussion Symptom Scale total score and the ImPACT cognitive composite scores. Those with≥2 prior concussions reported more symptoms than those with 0 concussions (d=0.43–0.46). Multiple regressions examining the contribution of concussion history and developmental/health history to symptom reporting showed the most significant predictors of symptoms scores were (in descending order): treatment for a psychiatric condition, treatment for headaches, history of learning disability (in boys only), history of attention-deficit/hyperactivity disorder, and age. Concussion history was the weakest statistically significant predictor in boys and not significant in girls. Cognitively, boys with 1 prior concussion had worse speed those with 0 concussions (d=0.11), and girls with≥2 prior concussions had worse verbal/visual memory than girls with 0 concussions (ds=0.38–0.39). In summary, youth with≥2 prior concussions reported more symptoms than those with no concussions. Boys with multiple concussions performed similarly on cognitive testing, while girls had worse memory scores.

scholarly journals The Effect of Pretest Exercise on Baseline Computerized Neurocognitive Test Scores

2017 ◽  
Vol 5 (10) ◽  
pp. 232596711773449 ◽  
Author(s):  
Alec Pawlukiewicz ◽  
Aaron M. Yengo-Kahn ◽  
Gary Solomon
Keyword(s):  
Decision Making ◽  
Test Scores ◽  
Adolescent And Young Adult ◽  
Return To Play ◽  
Strenuous Exercise ◽  
History Of ◽  
Baseline Testing ◽  
Baseline Test ◽  
Composite Scores ◽  
The Impact

Background: Baseline neurocognitive assessment plays a critical role in return-to-play decision making following sport-related concussions. Prior studies have assessed the effect of a variety of modifying factors on neurocognitive baseline test scores. However, relatively little investigation has been conducted regarding the effect of pretest exercise on baseline testing. Purpose/Hypothesis: The aim of our investigation was to determine the effect of pretest exercise on baseline Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) scores in adolescent and young adult athletes. We hypothesized that athletes undergoing self-reported strenuous exercise within 3 hours of baseline testing would perform more poorly on neurocognitive metrics and would report a greater number of symptoms than those who had not completed such exercise. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The ImPACT records of 18,245 adolescent and young adult athletes were retrospectively analyzed. After application of inclusion and exclusion criteria, participants were dichotomized into groups based on a positive (n = 664) or negative (n = 6609) self-reported history of strenuous exercise within 3 hours of the baseline test. Participants with a positive history of exercise were then randomly matched, based on age, sex, education level, concussion history, and hours of sleep prior to testing, on a 1:2 basis with individuals who had reported no pretest exercise. The baseline ImPACT composite scores of the 2 groups were then compared. Results: Significant differences were observed for the ImPACT composite scores of verbal memory, visual memory, reaction time, and impulse control as well as for the total symptom score. No significant between-group difference was detected for the visual motor composite score. Furthermore, pretest exercise was associated with a significant increase in the overall frequency of invalid test results. Conclusion: Our results suggest a statistically significant difference in ImPACT composite scores between individuals who report strenuous exercise prior to baseline testing compared with those who do not. Since return-to-play decision making often involves documentation of return to neurocognitive baseline, the baseline test scores must be valid and accurate. As a result, we recommend standardization of baseline testing such that no strenuous exercise takes place 3 hours prior to test administration.

scholarly journals A Cohort Study of the Temporal Stability of ImPACT Scores Among NCAA Division I Collegiate Athletes: Clinical Implications of Test–Retest Reliability for Enhancing Student Athlete Safety

2020 ◽  
Vol 35 (7) ◽  
pp. 1131-1144
Author(s):  
Sara J Mason ◽  
Bradley S Davidson ◽  
Marybeth Lehto ◽  
Aurélie Ledreux ◽  
Ann-Charlotte Granholm ◽  
...  
Keyword(s):  
Reaction Time ◽  
Ncaa Division I ◽  
Verbal Memory ◽  
Temporal Stability ◽  
Division I ◽  
Cognitive Test ◽  
Motor Speed ◽  
Visual Motor ◽  
Composite Scores ◽  
The Impact

Abstract Objective In this study we examined the temporal stability of the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) within NCAA Division I athletes across various timepoints using an exhaustive series of statistical models. Methods Within a cohort design, 48 athletes completed repeated baseline ImPACT assessments at various timepoints. Intraclass correlation coefficients (ICC) were calculated using a two-way mixed effects model with absolute agreement. Results Four ImPACT composite scores (Verbal Memory, Visual Memory, Visual Motor Speed, and Reaction Time) demonstrated moderate reliability (ICC = 0.51–0.66) across the span of a typical Division I athlete’s career, which is below previous reliability recommendations (0.90) for measures used in individual decision-making. No evidence of fixed bias was detected within Verbal Memory, Visual Motor Speed, or Reaction Time composite scores, and minimal detectable change values exceeded the limits of agreement. Conclusions The demonstrated temporal stability of the ImPACT falls below the published recommendations, and as such, fails to provide robust support for the NCAA’s recommendation to obtain a single preparticipation cognitive baseline for use in sports-related concussion management throughout an athlete’s career. Clinical interpretation guidelines are provided for clinicians who utilize baseline ImPACT scores for later performance comparisons.

scholarly journals The Association Between Past Speech Therapy and Preseason Symptom Reporting in Adolescent Student Athletes

2019 ◽  
Vol 34 (5) ◽  
pp. 752-752
Author(s):  
K Reese ◽  
D P Terry ◽  
B Maxwell ◽  
R Zafonte ◽  
P D Berkner ◽  
...  
Keyword(s):  
Student Athletes ◽  
Speech Therapy ◽  
Therapy Group ◽  
Effect Sizes ◽  
Symptom Reporting ◽  
Control Group ◽  
Emotional Symptoms ◽  
Falling Asleep ◽  
History Of ◽  
The Impact

Abstract Purpose Neurodevelopmental conditions, such as ADHD, have been shown to be associated with different baseline symptom reporting, but the relationship between a history of speech therapy and symptom reporting is not well understood. This study examined the association between prior speech therapy and baseline symptom reporting in student athletes. Methods A preseason baseline database contained 40,378 athletes ages 13–18 who had not sustained a concussion in the past 6 months. Of these, 27,550 athletes denied having all developmental/health conditions (controls) and 1,497 reported only having history of speech therapy (total sample: age M=15.5, SD=1.26; 47% girls). Mann-Whitney U-Tests were used to compare baseline symptom reporting on the ImPACT® Post-Concussion Symptom Scale between athletes with prior speech therapy and controls. Individual symptoms were dichotomized (absent vs. present) and compared between groups using chi-square tests. Results There was a higher proportion of boys in the prior speech therapy group than in the control group (62% vs. 53%; X2=41.9, p<.001). Athletes with speech therapy histories reported greater overall baseline symptoms (ps<.001). The effect sizes were minimal-to-small (Cohen’s d: girls= 0.10; boys=0.20). Slightly higher portions of boys and girls with a history of speech therapy reported trouble falling asleep, fatigue, and difficulty concentrating/ remembering compared to their control counterparts (ps<.05). Further, compared to controls, a higher portion of boys (but not girls) with speech therapy histories reported physical and emotional symptoms. Conclusion Adolescents with speech therapy histories report slightly more symptoms than controls during baseline testing, with a stronger effect in boys. However, effect sizes were very small.

scholarly journals Disparities in Kangaroo Care for Premature Infants in the Neonatal Intensive Care Unit

2020 ◽  
Author(s):  
Edith Brignoni-Pérez ◽  
Melissa Scala ◽  
Heidi M. Feldman ◽  
Virginia A. Marchman ◽  
Katherine E. Travis
Keyword(s):  
Socioeconomic Status ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Clinical Staff ◽  
Group Differences ◽  
Language Group ◽  
Kangaroo Care ◽  
Language Groups ◽  
Family Language ◽  
Family Ses

AbstractOBJECTIVESThe aim of this study was to investigate whether preterm infants whose families have lower socioeconomic status (SES) or communicate with clinical staff in a language other than English experience differences in the total amount, frequency, and duration of Kangaroo Care (KC) compared to preterm infants of higher SES or primarily English-speaking families.METHODSParticipants were infants born <32 weeks gestational age (GA), N=116. We defined family SES by the infants’ health insurance (private/higher vs. public/lower) and family language by the language mothers used to communicate with clinical staff (English vs. Other language). Family SES or family language groups were compared on: (1) the total amount of KC infants experienced during hospitalization; (2) frequency of KC per visitation days; and, (3) duration of KC events per day.RESULTSInfants in the lower SES and Other language groups experienced KC in reduced amounts, lower frequencies, and shorter durations than infants in either the higher SES or English language groups. SES and language group differences remained significant after controlling for family visitation and GA at birth. After controlling for SES, language group differences in KC duration remained significant.CONCLUSIONSOur findings revealed disparities in the total amount, frequency, and duration of KC in the neonatal intensive care unit as a function of both family SES and language families used to communicate with clinical staff. These disparities reduced infants’ access to this developmental care practice shown to stabilize clinical status and promote neurodevelopment. We recommend that hospital nurseries implement policies that minimize such disparities.Table of Contents SummaryTotal amount, frequency, and duration of Kangaroo Care for preterm infants in the NICU varied as a function of family’s socioeconomic status and language.What’s Known on This SubjectIn the United States, disparities in health care delivery and medical outcomes have been identified on the basis of patient or family socioeconomic status and the language patients or families use to communicate with clinical staff.What This Study AddsExtending to the NICU, the amount, frequency, and duration of Kangaroo Care experienced by preterm infants differed both by family’s socioeconomic status and the language families use to communicate with clinical staff. Policy changes are needed to reduce these disparities.Contributors’ Statement PageDr. Brignoni-Pérez conceptualized and designed the study, acquired data from the electronic medical record, analyzed the data, drafted the initial manuscript, and reviewed and revised the manuscript. Drs. Scala, Marchman, Feldman, and Travis conceptualized and designed the study, supervised data abstraction and analysis, and critically reviewed and revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Sign in / Sign up

Export Citation Format

Share Document