Title: A Normative Study of the Sport Concussion Assessment Tool (SCAT2) in Children and Adolescents
Abstract: AbstractRecent clinical practice parameters encourage systematic use of concussion surveillance/management tools that evaluate participating athletes at baseline and after concussion. Office-based tools (Sports Concussion Assessment Tool; SCAT2) require accurate baseline assessment to maximize utility but no normative data exist for children on the SCAT2, limiting identification of "normal" or "impaired" score ranges. The purpose of this study was to develop child and adolescent baseline norms for the SCAT2 to provide reference values for different age groups. A community-based approach was implemented to compile baseline performance data on the SCAT2 in 761 children aged 9 to 18 to create age- and sex-graded norms. Findings indicate a significant age effect on SCAT2 performance such that older adolescents and teenagers produced higher (better) total scores than younger children (ages 9 to 11) driven by age differences on individual components measuring cognition (SAC), postural stability (BESS), and symptom report. Females endorsed greater numbers of symptoms at baseline than males. Normative data tables are presented. Findings support the SCAT2 as a useful clinical tool for assessing baseline functioning in teenagers, but suggest clinical utility may be limited in children under age 11. Follow-up studies after incident concussion are needed to confirm this assumption.Keywords: SCAT2Concussion assessmentSport-related concussionChildAdolescentStandardized Assessment of ConcussionSACBalance Error Scoring SystemBESS. AcknowledgmentsWe gratefully acknowledge the contributions of Brady Tripp, PhD and the University of Florida students who assisted in data collection: Alicia Moran-Suffrinko, Amanda Smith, Callie Beck Dunn, Cary Gibbons, Daniel Gering, Daniel Schonfeld, David Marra, Jason Gravano, Joseph Gullett, Karlyn Vatthauer, Kelsey Thomas, Kristen Medina, Lauren Hearn, Manal Alabduljabbar, Melanie Faust, Paul Mangal, Peter Nguyen, Rachel Postupack, Sarah Greif, Sarah Szymkowicz, Scott Szymanski, Talia Seider, Tanisha Hill-Jarett, Taylor Kuhn, Zan Shareef, and Zander Daniel.Health IMPACTS for Florida Network author list: Michelle Vinson, MS; Jessica De Leon, PhD; Jevetta Stanford, EdD; David M. Duany, MD, FAAP; Penelope Tokarski-Savona, MD; Odett Stanley-Brown, MD, FAAP; Veenod L. Chulani, MD, MSEd; Fernando Suarez, MD; Robert Colyer, Jr., MD; Thomas Connolly, MD; J. Douglas McDonald, MD; Susan LaJoie, ARNP, MSN; Lara Balbis, MSN, ARNP; Joseph F. Savona, MD, FAAP; Nicole L. Cameron, MD, FAAP; S. Elizabeth Davis, MD; Erin Frick, MD, CAQ SM; Mark B. DiDea, MD, FAAP; Jacquelyn H. Nystrom, MD, MPH; Ronald L. Machado, MD; Donald A. Zorn, MD; Thomas A. Lacy, MD; Sally Elias, MD; Jennifer M. Lynch, ARNP; Elizabeth Hengstebeck, DO; Jason Salagubang, MD.This work was supported by State of Florida under Grant number NCATS UL1 RR029890-03S3; NIH/NCATS Clinical and Translational Science Award to the University of Florida under Grant number UL1 TR000064.The authors have no relevant financial relationships to this article to disclose. The authors have no conflicts of interest to disclose.