Poster Session 10 Program Schedule
02/17/2024
09:00 am - 10:15 am
Room: Majestic Complex (Posters 61-120)
Poster Session 10: Neurodevelopmental | Congenital Conditions
Final Abstract #97
Psychometric Examination of the Child SCAT3 in Youth age 5-12
Gerard Gioia, Children's National Hospital, Washington, United States
Hailey Johnson, Children's National Hospital, Washington, United States
Andree-Anne Ledoux, University of Ottawa, Ottawa, Canada
Roger Zemek, University of Ottawa, Ottawa, Canada
Christopher Vaughan, Children's National Hospital, Washington, United States
Category: Concussion/Mild TBI (Child)
Keyword 1: concussion/ mild traumatic brain injury
Keyword 2: child brain injury
Keyword 3: assessment
Objective:
The systematic review of concussion literature conducted for the 2022 Amsterdam Concussion in Sport Group (CISG) meeting revealed a significant dearth of published papers for children ages 5-12. We examined the psychometrics of the Child SCAT3 administered in the Canadian Emergency Departments for the 5P study (Zemek et al., 2016) to understand the overall value of this tool in early diagnosis and management in the 5-12 age group and to specifically examine any differences in psychometrics between sport and non-sport mechanisms of injury.
Participants and Methods:
Primary sample was 5-7 year olds (n=507, 61%male) and 8-12 (n =1241, 66% male) with contrast group 13-17 year olds (n=1226, 59% male), seen in the Emergency Dept. on average 8 hours post-injury. Injury mechanisms were classified as Sport (n=767) and Non-sport (n=1610). Administered SCAT3 Cognitive subtests: Reverse digits (0-5), 5-word list learning, 3 trials (0-15), word list delayed recall (0-5); and Balance Error Scoring System (BESS, double leg and tandem stance total errors, 0-20).
Results:
Stepwise developmental differences were found for the Reversed Digits and 5-word list learning tasks across the 3 age groups; only the 5-7 year group performed lower than the older groups on Delayed Recall and BESS measures. Sport compared to non-sport groups showed no differences on any cognitive measure; the sport group exhibited fewer BESS errors. Boys and girls performed similarly across the age groups on all cognitive measures. A small but significant difference was found in the 5-7 group for BESS errors with females exhibiting more errors. Intercorrelations among the 3 cognitive measures were low to moderate across the 3 age groups. The relationship of the ED SCAT3 to standardized cognitive measures at 4 weeks (CVLT 5 learning trials, Short Delay; WASI Full-2, Digit Span) reveals moderate correlations (r’s=0.3 to 0.5), with a lower correlation with WASI Full-2 (r’s=0.18 to 0.27). Smaller (r < .25) but significant correlations were found between the BESS and the standardized cognitive measures, except Digit Span. Sport and non-sport injury groups exhibited similar patterns of correlations. For the 8-12 group, SCAT3 measures were significantly associated with symptom severity at the Emergency Department, particularly for the balance measures (p<.001) such that higher balance errors were associated with higher symptom severity with a stepwise decline across symptom severity levels.
Conclusions:
The SCAT3 administered in the ED demonstrated evidence of marginal psychometric characteristics with age-based trends in performance, no differences between boys/girls, no overall differences between sport and non-sport related injury groups, low internal consistency due in part to only component 3 scores, and adequate predictive validity with standardized cognitive performance at 4 weeks. The SCAT3 balance measure in 8-12 year olds is related to concurrent symptom severity levels. These findings suggest the need for further refinement of the SCAT3 tool as well as recognition that the sport/non-sport dichotomy is not supported in establishing its psychometric properties.
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