The objective of this study was to examine differences in neurocognitive performance between symptomatic concussed athletes, a group of concussed athletes with no subjective symptoms, and a non-concussed control group of athletes. All concussed athletes were evaluated within one week of injury using the ImPACT computerized test battery. Results indicate that concussed athletes who denied subjective symptoms demonstrated poorer performance than control subjects on all four composite scores of the ImPACT test batters (Verbal Memory, Visual Memory, Reaction Time and Processing Speed However, the concussed but asymptomatic group demonstrated significantly better performance than did the concussed and symptomatic group. Thus, concussed athletes who did not report subjective symptoms were not fully recovered based on neurocognitive testing. This study underscores the importance of neurocognitive testing in the assessment of concussion sequelae and recovery.

This article reviews the status of concussion management in child and adolescent athletes. Children and adolescent athletes represent a distinct group from adult athletes, although past concussion guidelines have not specifically addressed these differences. It is the position of this article that younger athletes need to be considered as a separate group and that conservative management of concussion is often called for. Neurodevelopmental differences between adult and child athletes are highlighted and new developments in the management of concussion in youth sports are discussed.

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With youth sports participation and concern about sports-related concussions both on the rise, it is important to properly measure cognitive function to ensure the clinical utility of baseline testing. Computerized testing batteries are often employed as baseline and postinjury measures of cognitive function, with the Immediate Postconcussion Assessment and Cognitive Testing (ImPACT) being the most used of all the current testing platforms. The current study compared 10- to 12-year-old children across the composite scores yielded by the ImPACT and provided normative data on each of the subtests used to calculate the composite scores. Normative data are separated by gender for athletes aged 10 to 12 years old, as this is the current age bracket used by the ImPACT. These norms may be helpful in the interpretation of the ImPACT clinical report and further delineation of areas of neurocognitive dysfunction.