title: Baseline SCAT2 Assessment of Healthy Youth Student-Athletes: Preliminary Evidence for the Use of the Child-SCAT3 in Children Younger Than 13 Years.
abstract: OBJECTIVE
  To compare baseline scores of middle and high school students on the Sport Concussion Assessment Tool 2 (SCAT2) by sex and age.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Single private school athletic program.
  
  
  METHODS
  Three hundred sixty-one middle and high school student-athletes.
  
  
  METHODS
  Preseason SCAT2 was administered to student-athletes before athletic participation.
  
  
  METHODS
  Total SCAT2 score, symptoms, symptom severity, Glasgow coma scale, modified Balance Error Scoring System (BESS), coordination, and Standardized Assessment of Concussion (SAC) with subsections: Orientation, Immediate Memory, Concentration, and Delayed Recall.
  
  
  RESULTS
  No differences were found in total SCAT2 scores between sex (P = 0.463) or age (P = 0.21). Differences were found in subcomponents of the SCAT2. Twelve year olds had significantly lower concentration scores (3.3 ± 1.2) than 15 and 18 year olds (3.9 ± 1.0 and 4.2 ± 1.0, respectively). The 12 year olds also had the lowest percentage of correct responses for the SAC's concentration 5-digit (46%), 6-digit (21%), and months' backward (67%) tasks. Females presented with more symptoms (20.0 ± 2.2 vs. 20.6 ± 2.1 P = 0.007) better immediate memory (14.6 ± 0.9 vs. 14.3 ± 1.0, P = 0.022) and better BESS scores (27.2 ± 2.3 vs. 26.6 ± 2.6, P = 0.043) than their male counterparts.
  
  
  CONCLUSIONS
  Normative values for total SCAT2 and subscale scores show differences in concentration between ages, whereas symptoms, BESS, and immediate memory differed between sexes. We also found that 12 year olds have increased difficultly with the advanced concentration tasks, which lends support to the development of a separate instrument, such as the Child-SCAT3. The presence of developmental differences in the younger age groups suggests the need for annual baseline testing.
  
  
  CONCLUSIONS
  Subtle differences between age and sex have been identified in many components of the SCAT2 assessment. These differences may support the current evolution of concussion assessment tools to provide the most appropriate test. Baseline testing should be used when available, and clinicians should be aware of potential differences when using normalized values.
authors.affiliation: *Department of Kinesiology, Exercise and Sport Injury Laboratory, University of Virginia, Charlottesville, Virginia; †Saint Anne's Belfield School, Charlottesville, Virginia; Departments of ‡Neurology; and §Psychiatry and Neurobehavioral Science, University of Virginia, Charlottesville, Virginia; and ¶Department of Human Services Kinesiology Program Area, Curry School of Education, University of Virginia, Charlottesville, Virginia.
authors.forename: Neal R
authors.initials: NR
authors.lastname: Glaviano
authors.forename: Shari
authors.initials: S
authors.lastname: Benson
authors.forename: Howard P
authors.initials: HP
authors.lastname: Goodkin
authors.forename: Donna K
authors.initials: DK
authors.lastname: Broshek
authors.forename: Susan
authors.initials: S
authors.lastname: Saliba
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001265:Athletic Injuries / Q000175:diagnosis* / Q000523:psychology; D001288:Attention; D001924:Brain Concussion / Q000175:diagnosis* / Q000523:psychology; D002648:Child; D003243:Consciousness; D003430:Cross-Sectional Studies; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008568:Memory; D008570:Memory, Short-Term; D011939:Mental Recall; D009483:Neuropsychological Tests; D009949:Orientation; D004856:Postural Balance; D055815:Young Adult