Sports related concussions, or mild traumatic brain injuries, have been steadily increasing over the past two decades. Effective screening and identification of concussions play a critical role in the diagnosis and rehabilitation process. Although side line assessment tools are available, there are few well validated tests available to assist medical providers in this decision-making process. This study aims to determine whether previously validated tools which assess neurocognitive and neurophysiological abilities can predict concussion symptom endorsement in a sample of child and adolescent athletes.

Participants were recruited from two settings: The office of a pediatric neurologist (seen 3 to 109 days post incident) and from preseason baseline assessments.

Method: Participants were 113 individuals, aged 6 to 17, representing 84 consecutive cases of individuals completing standardized baseline assessments with no recent history of concussion, and 29 consecutive cases undergoing a post-concussion evaluation by a pediatric neurologist. Participants completed a standardized battery of tests comprised of the Connors’ Continuous Performance Test (CPT-3), the Balance Error Scoring System (BESS) and the NIH 4-meter Gait Test and completed a checklist of CDC concussion symptoms.

Results: The screening battery explained 33% of the variance (d = 1.4) in concussion symptom endorsement, after controlling for age. The neurocognitive test alone (CPT-3) accounts for 21.5% of the variance (d = 1.05) in symptoms after controlling for age, and the neurobehavioral measures (BESS and NIH 4m Gait) then account for an additional 11.5% variance (they account for 18.6% variance, d = .96, when entered first). These effect sizes are considered large to very large and reflect a marked increase in predictive validity relative to existing measures used in concussion assessments.

Conclusions: An easy to administer and relatively brief screening test can be used in medical settings to identify concussions and predict significant and substantial variability in CDC concussion symptoms.