Neuropsychological management of concussion in children and adolescents: Effects of age & gender on ImPACT

British Journal of Sports Medicine -


Gioia, G. A., J. A. Janusz, K. Gilstein and G. L. Iverson.



Introduction: Neuropsychological assessment has become an essential component in the management of sports concussions. While adolescents and adults demonstrate excellent reliability and validity on ImPACT, the need exists for developmentally-appropriate assessment tools in younger children. We examine gender and age effects on neuropsychological, performance in a normative sample age 11–18 years with ImPACT, a battery designed for sports concussions. Method/Results: ImPACT 2.1, tapping attention, verbal and visual memory storage/retrieval, processing speed, and reaction time, was administered to 635 participants (451 boys, 184 girls), age 11–18, with no history of learning, attentional, neurological, or psychiatric disorders. Inspection of the distributions of all task variables at each age level reveals appropriate dispersion. Differences in performance between the 8 age groups and 2 genders on the 5 ImPACT Composites were examined via MANOVA. Clear developmental trends were present for all composites (Verbal Memory p<0.04, Visual Memory p<0.01, Processing Speed P<0.001, Reaction Time p<0.01, Impulse Control p<0.01) while only marginal gender differences were evident for Verbal Memory and Processing Speed (p<0.06), and no age x gender interactions. Post hoc tests of specific ages found consistent linear effects with increasing performance with age. Conclusions: The current findings support the use of ImPACT for children as young as age 11. Reasonable distribution of scores are found at all age levels, Significant increases in performance associated with advancing development are evident for each of the neuropsychological domains, while only marginal differences were noted between boys and girls. While these findings have significant implications for the clinical utility of ImPACT at younger ages, further detailed scale-level analyses are planned.

Links to full article: