Start Date
17-6-2025 3:00 PM
End Date
17-6-2025 4:30 PM
Invalidity Rates of Baseline ImPACT Concussion Assessments in High School Athletes with Disabilities
Abstract
Invalidity Rates of Baseline ImPACT Concussion Assessments in High School Athletes with Disabilities
Introduction
The Immediate Postconcussion Assessment and Cognitive Testing (ImPACT) is the most common computerized concussion assessment tool (Dessy, 2017). Previous studies showed higher rates of invalid baselines in individuals with autism, learning disabilities (LD) and Attention-Deficit/Hyperactivity Disorder (ADHD) (Maietta, 2021). Characteristics of these disabilities can resemble concussion symptoms which may complicate the evaluation process and diagnosis of concussion, a health concern in athletes (Harmon, 2013). This study aims to investigate invalidity rates of baseline ImPACT assessments among disability groups in high school athletes to explore its use in this population.
Methodology
This retrospective study analysed ImPACT (versions 4.0 & up) baseline assessments between 2021-2023 from 62 high schools in Hawai'i. Participants were divided into groups based on self-reported disability: No disability, LD, ADHD, dyslexia, autism and accompanying neurodevelopmental disorders (ND), dyslexia and ADHD, LD with ADHD and dyslexia. ImPACT software automatically flags invalid assessments upon completion. Invalidity rates were calculated for each disability group and a chi-squared(χ²) goodness of fit test was completed to determine invalidity rates(%) between disability groups.
Results
25,275 participants (female=9,926, male=15,349) aged 15.35±1.14 were included. χ² analysis revealed significant association between invalid baselines and disability groups [χ² (7, n=25275) =70.753, p<.001]. Overall invalidity rate for all athletes was 7.15%. Individuals with LD (13.71%) and autism with accompanying ND’s (13.1%) had the highest rate of invalid baseline tests across groups.
Conclusions
Athletes with self-reported disabilities and ND’s elicit higher rates of invalid ImPACT baseline assessments potentially impacting healthcare. Instruments with increased sensitivity should be validated for use in individuals with disabilities.
References
Dessy, A. M., Yuk, F. J., Maniya, A. Y., Gometz, A., Rasouli, J. J., Lovell, M. R., & Choudhri, T. F. (2017). Review of assessment scales for diagnosing and monitoring sports-related concussion. Cureus, 9(12), e1922.
Harmon, K. G., Drezner, J., Gammons, M., Guskiewicz, K., Halstead, M., Herring, S., Kutcher, J., Pana, A., Putukian, M., Roberts, W., & American Medical Society for Sports Medicine (2013). American Medical Society for Sports Medicine position statement: concussion in sport. Clinical journal of sport medicine: official journal of the Canadian Academy of Sport Medicine, 23(1), 1–18.
Maietta, J. E., Barchard, K. A., Kuwabara, H. C., Donohue, B. D., Ross, S. R., Kinsora, T. F., & Allen, D. N. (2021). Influence of special education, ADHD, autism, and learning disorders on ImPACT validity scores in high school athletes. Journal of the International Neuropsychological Society: JINS, 27(5), 461–471.
Word Count
250/250
Recommended Citation
Glodowski, Kiera; Furutani, Troy; Murata, Nathan; and Tsuchida, Allison, "Invalidity Rates of Baseline ImPACT Concussion Assessments in High School Athletes with Disabilities" (2025). International Symposium of Adapted Physical Activity and International Symposium on Physical Activity and Visual Impairment and Deafblindness. 66.
https://sword.mtu.ie/isapa/2025/day2/66
Invalidity Rates of Baseline ImPACT Concussion Assessments in High School Athletes with Disabilities
Invalidity Rates of Baseline ImPACT Concussion Assessments in High School Athletes with Disabilities
Introduction
The Immediate Postconcussion Assessment and Cognitive Testing (ImPACT) is the most common computerized concussion assessment tool (Dessy, 2017). Previous studies showed higher rates of invalid baselines in individuals with autism, learning disabilities (LD) and Attention-Deficit/Hyperactivity Disorder (ADHD) (Maietta, 2021). Characteristics of these disabilities can resemble concussion symptoms which may complicate the evaluation process and diagnosis of concussion, a health concern in athletes (Harmon, 2013). This study aims to investigate invalidity rates of baseline ImPACT assessments among disability groups in high school athletes to explore its use in this population.
Methodology
This retrospective study analysed ImPACT (versions 4.0 & up) baseline assessments between 2021-2023 from 62 high schools in Hawai'i. Participants were divided into groups based on self-reported disability: No disability, LD, ADHD, dyslexia, autism and accompanying neurodevelopmental disorders (ND), dyslexia and ADHD, LD with ADHD and dyslexia. ImPACT software automatically flags invalid assessments upon completion. Invalidity rates were calculated for each disability group and a chi-squared(χ²) goodness of fit test was completed to determine invalidity rates(%) between disability groups.
Results
25,275 participants (female=9,926, male=15,349) aged 15.35±1.14 were included. χ² analysis revealed significant association between invalid baselines and disability groups [χ² (7, n=25275) =70.753, p<.001]. Overall invalidity rate for all athletes was 7.15%. Individuals with LD (13.71%) and autism with accompanying ND’s (13.1%) had the highest rate of invalid baseline tests across groups.
Conclusions
Athletes with self-reported disabilities and ND’s elicit higher rates of invalid ImPACT baseline assessments potentially impacting healthcare. Instruments with increased sensitivity should be validated for use in individuals with disabilities.
References
Dessy, A. M., Yuk, F. J., Maniya, A. Y., Gometz, A., Rasouli, J. J., Lovell, M. R., & Choudhri, T. F. (2017). Review of assessment scales for diagnosing and monitoring sports-related concussion. Cureus, 9(12), e1922.
Harmon, K. G., Drezner, J., Gammons, M., Guskiewicz, K., Halstead, M., Herring, S., Kutcher, J., Pana, A., Putukian, M., Roberts, W., & American Medical Society for Sports Medicine (2013). American Medical Society for Sports Medicine position statement: concussion in sport. Clinical journal of sport medicine: official journal of the Canadian Academy of Sport Medicine, 23(1), 1–18.
Maietta, J. E., Barchard, K. A., Kuwabara, H. C., Donohue, B. D., Ross, S. R., Kinsora, T. F., & Allen, D. N. (2021). Influence of special education, ADHD, autism, and learning disorders on ImPACT validity scores in high school athletes. Journal of the International Neuropsychological Society: JINS, 27(5), 461–471.
Word Count
250/250