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Study validates concussion assessment tools for children

American Academy of Pediatrics News Jul 29, 2017

The Sport Concussion Assessment Tool (SCAT3) and its counterpart ChildSCAT3 both differentiated emergency department patients who did and did not have a concussion. The measures include assessments of the child’s neck, symptoms, cognitive function, coordination and balance.

“The present findings are of importance as they provide evidence to validate the widespread use of SCAT3 and ChildSCAT3 in pediatric populations,” authors wrote in the journal Pediatrics study titled, “Accuracy of Components of SCAT to Identify Children with Concussion.”

Children ages 8–19 visited U.S. emergency departments about 502 times for concussion from 2001–’05, according to the study. Research on the validity of the ChildSCAT3 test has been limited. Therefore, researchers studied children ages 5–16 at a hospital in Australia from May 2014 to April 2015.

The 264 children were divided into three groups – those clinically diagnosed with a concussion by an emergency physician, those with upper limb injuries and those who were not injured. The latter two groups served as controls.

Children ages 5–12 were given the ChildSCAT3, and those 13 and older were given the SCAT3.

Results for both older and younger children showed the concussed patients’ number and severity of symptoms were significantly different from that of the control groups.

On the SCAT3, there were differences between the concussion group and at least one control group for 19 of 22 symptoms. On the ChildSCAT3, the same was true for 18 of 20 child–reported symptoms and the same number of parent–reported symptoms.

Most of the subtests making up the SCAT3 and ChildSCAT3 also showed differences between children with and without a concussion. Immediate memory, tandem leg stance errors and balance tests made this distinction for both age groups.

There was not a significant difference in concussion test scores between the uninjured and upper limb injury groups.

“Given the non–specific nature of many concussion symptoms, the present findings provide important evidence to support the validity of both SCAT3 and ChildSCAT3 to distinguish children who have experienced a concussion from those with other common pediatric injuries at acute presentation,” authors wrote.
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