The Sport Concussion Assessment Tool-Second Edition and its Relationship with Attention and Verbal Learning in a Pediatric Population

Abstract

Concussions affect over 3.8 million Americans annually, and youths comprise the majority of those affected. "Return to play" (RTP) and "return to think" (RTT) decisions following concussions are based on the assessment of several factors including symptom resolution and neuropsychological functioning. The Sport Concussion Assessment Tool-Second Edition (SCAT-2) was developed as a sideline assessment tool to aid in these decisions. Clinicians may infer neuropsychological status from results of the tool, but no studies have directly examined validity of this relationship. Fifty-seven concussed participants between the ages of 10 and 19 were assessed using the SCAT-2 as well as with a memory task (California Verbal Learning Test [CVLT]) and a computerized measure of attention (Conners' Continuous Performance Test II [CPT-II]). Performance on the Standardized Assessment of Concussion [SAC] scale, a component of the SCAT-2, was associated with verbal learning and various measures of inattention. Implications of these findings for concussion assessment and future research are discussed.

Predictors of neuropsychological outcome after pediatric concussion.

“…To our knowledge, this is the first evidence that subcomponents of the SAC-C may be important predictors of reduced neuropsychological performance 1 month after concussion. A previous study (O’Neill et al, 2015) showed that poorer SAC performance predicted more inattention and impulsivity on the CPT measure, as well as poorer verbal learning on the CVLT (measures that were also used in this study). However, participants in that study completed the SAC and neuropsychological tests concurrently, within 100 days of their concussion, rather than the acute (SAC-C) and longitudinal (neuropsychology) approach used in the current study.…”

Predicting Wellness After Pediatric Concussion

“…This test of working memory assesses performance based on backward digit span and recitation of the months of the year in reverse order. To our knowledge, only two other studies (Beauchamp et al, 2018;O'Neill et al, 2015) have focused on the predictive utility of this measure in concussion, despite its inclusion in the widely used Sports Concussion Assessment Tool (Davis et al, 2017). A previous study in the same sample found that the SAC immediate memory and concentration subtests were predictive of better neuropsychological performance at 4 and 12 weeks post-injury (Beauchamp et al, 2018).…”