A-35 Utility of the Child SCAT-5 for Identifying Concussion In Children Aged 5–9 Years

Abstract

Abstract Purpose: The Sport Concussion Assessment Tool-5 Child (Child SCAT-5) is designed to assess concussion in children aged 5 to 12 years and includes child- and parent-reported symptoms, as well as brief cognitive and balance screening. However, researchers have yet to examine the utility of the Child SCAT-5 for identifying concussion in young (5–9 years) children. Methods: 139 total participants aged 5–9 years (M = 7.31 ± 1.15, 43.9% female) consisted of 96 participants presenting within 30 days of concussion (M = 8.90 ± 5.78 days; 38.5% sport-related) and 43 healthy age- and gender-matched controls. Participants and parents completed a clinical interview and Child SCAT-5 at their first visit. Receiver operating characteristic (ROC) curves were estimated on the Child SCAT-5 balance and cognitive screening components, parent and child total and symptom severity reports, as well as each individual parent- and child-rated symptom’s severity. Results: Area under the curve (AUC) values fell between 0.32 and 0.64 for cognitive, balance, and symptom rating components. Variables with highest AUC values included parent-rated symptoms worsening after physical activity (0.73) and cognitive activity (0.72). Individual symptom severity items with highest AUC values included headaches (parent = 0.89; child = 0.81), tired a lot (parent = 0.75), and tired easily (parent = 0.72; child = 0.72). Conclusions: Results suggest the Child SCAT-5’s individual symptoms were useful in identifying concussion, but cognitive/balance domains were not. Parent-rated symptom worsening after cognitive/physical activity fell in the acceptable range. Results support use of the Child SCAT-5 symptom components as part of a multifaceted concussion evaluation.