Concussion baseline testing has been advocated for the assessment of pre-morbid function. When individual baseline scores are unavailable, utilizing normative values is recommended. However, the validity of generalizing normative data across multiple socioeconomic environments is unknown.
Objective: mimic the normative data creation of ImPACT™ to examine the effect of socioeconomic status (SES) on ImPACT™ composite scores.
Methods: A retrospective cross-sectional design analyzed completed computerized neuropsychological test data (ImPACT™) obtained to establish the baseline scores of cognitive function from males aged 13-15 years (n = 300) and 16-18 years (n = 331) from an urban high school system. Comparisons between baseline scores and normative ImPACT™ values were calculated utilizing t-tests with ImPACT™ composite scores serving as dependent variables.
Results: significant differences between age-dependent urban composite scores and ImPACT™ normative values for 13-15- and 16-18-year-olds were found for Composite Verbal Memory, Composite Visual Memory, Composite Motor and Composite Reaction Time (p < 0.01).
Conclusions: Significant differences exist between urban high school athletes and ImPACT™-provided age-dependent normative scores, with urban participants performing below age-dependent normative values. These findings support establishing SES appropriate normative values when baseline test scores are not available for direct comparison in order to provide better evaluation and post-concussion management across diverse populations.
Keywords: adolescent; baseline testing; concussion; low SES; social determinants of health.