{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T01:10:02Z","timestamp":1749690602941,"version":"3.41.0"},"reference-count":28,"publisher":"National Athletic Trainers' Association","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4]]},"abstract":"\n Context<\/jats:title>\n Neurocognitive testing is a critical tool in the management of sport-related concussions. Adversity during childhood and adolescence affects cognitive tasks, behavioral outcomes, and academic performance. Adversity may be important in baseline concussion test validity as well; however, the influence of these experiences is not well understood.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine the relationship between individual-level experiences of adversity and baseline test validity of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). We hypothesized that experiences of poverty, maltreatment, or extreme neighborhood deprivation would be associated with lower odds of baseline test validity.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Case-control study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Cuyahoga County, Ohio.<\/jats:p>\n <\/jats:sec>\n \n Patients or Other Participants<\/jats:title>\n A total of 6495 student-athletes born from 1995 through 2005 who completed a baseline ImPACT test between 10 and 18 years old and were identified in the Child-Household Integrated Longitudinal Data system, a comprehensive data system with demographic and social service usage outcomes for children in Cuyahoga County, Ohio.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measure(s)<\/jats:title>\n Baseline concussion test validity was determined using the ImPACT built-in validity measure. Experiences of adversity during the sensitive developmental periods of early childhood and adolescence were key independent variables.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Our findings suggested that social mobility may play an important role in baseline validity. Youth with upward social mobility (ie, poverty or neighborhood deprivation in early childhood only) were not different from youth without such experiences (odds ratio [OR] = 0.91, P<\/jats:italic> = .74). Youth with persistent adversity across childhood or downward social mobility (ie, poverty or high neighborhood deprivation in adolescence only) had 50% to 72% lower odds of achieving a valid baseline test (persistent poverty, OR = 0.59, P<\/jats:italic> = .05; adolescent poverty only, OR = 0.50, P<\/jats:italic> = .004; adolescent neighborhood deprivation only, OR = 0.28, P<\/jats:italic> < .001). Maltreatment had no significant effect on test validity.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n These findings indicated that certain patterns of adversity may predispose youth to invalid baseline testing scores, potentially increasing their risk of inappropriate injury management and poor outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.4085\/1062-6050-0502.22","type":"journal-article","created":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T20:36:57Z","timestamp":1677271017000},"page":"373-380","source":"Crossref","is-referenced-by-count":2,"title":["Experiences of Adversity and Validity of Baseline Concussion Testing"],"prefix":"10.4085","volume":"59","author":[{"given":"Alena Sorensen","family":"D\u2019Alessio","sequence":"first","affiliation":[{"name":"Department of Population and Quantitative Health Sciences, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH"},{"name":"Center on Poverty and Community Development, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meghan","family":"Salas Atwell","sequence":"additional","affiliation":[{"name":"Center on Poverty and Community Development, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siran","family":"Koroukian","sequence":"additional","affiliation":[{"name":"Department of Population and Quantitative Health Sciences, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Bailey","sequence":"additional","affiliation":[{"name":"University Hospitals Concussion Management Program, Neurological Institute, University Hospitals Cleveland Medical Center, OH. Ms D\u2019Alessio is now at the Department of Epidemiology, Gillings School of Global Public Health, and the Carolina Population Center, University of North Carolina at Chapel Hill. Dr Briggs is now at the Department of Public Health Sciences, University of Miami Miller School of Medicine, FL."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farren B. S.","family":"Briggs","sequence":"additional","affiliation":[{"name":"Department of Population and Quantitative Health Sciences, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2557","reference":[{"issue":"2","key":"i1062-6050-59-4-373-b01","series-title":"J Athl Train","first-page":"245","article-title":"National Athletic Trainers\u2019 Association. National Athletic Trainers\u2019 Association position statement: management of sport concussion","volume":"49","author":"Broglio","year":"2014","unstructured":"Broglio\n SP,\n \n \n Cantu\n RC,\n \n \n Gioia\n GA,\n \n et al.\n; National Athletic Trainers\u2019 Association. National Athletic Trainers\u2019 Association position statement: management of sport concussion. J Athl Train. 2014;49(2):245\u2013265. doi:10.4085\/1062-6050-49.1.07"},{"issue":"10","key":"i1062-6050-59-4-373-b02","series-title":"Sports Med","first-page":"1487","article-title":"Validity of the Immediate Post Concussion Assessment and Cognitive Testing (ImPACT)","volume":"46","author":"Alsalaheen","year":"2016","unstructured":"Alsalaheen\n B,\n \n \n Stockdale\n K,\n \n \n Pechumer\n D,\n \n \n Broglio\n SP.\n \n \n Validity of the Immediate Post Concussion Assessment and Cognitive Testing (ImPACT). Sports Med. 2016;46(10):1487\u20131501. doi:10.1007\/s40279-016-0532-y"},{"issue":"5","key":"i1062-6050-59-4-373-b03","series-title":"J Athl Train","first-page":"659","article-title":"Utility of repeated assessment after invalid baseline neurocognitive test performance","volume":"49","author":"Schatz","year":"2014","unstructured":"Schatz\n P,\n \n \n Kelley\n T,\n \n \n Ott\n SD,\n \n et al.\n\n Utility of repeated assessment after invalid baseline neurocognitive test performance. 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Clin Neuropsychol. 2022;36(7):1613\u20131636. doi:10.1080\/13854046.2020.1866676"},{"issue":"3","key":"i1062-6050-59-4-373-b05","series-title":"Arch Clin Neuropsychol","first-page":"259","article-title":"Sandbagging on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) in a high school athlete population","volume":"32","author":"Higgins","year":"2017","unstructured":"Higgins\n KL,\n \n \n Denney\n RL,\n \n \n Maerlender\n A.\n \n \n Sandbagging on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) in a high school athlete population. Arch Clin Neuropsychol. 2017;32(3):259\u2013266. doi:10.1093\/arclin\/acw108"},{"year":"2021","series-title":"ImPACT Administration and Interpretation Manual","key":"i1062-6050-59-4-373-b06","unstructured":"ImPACT Administration and Interpretation Manual\n . Version 4. ImPACT Applications; 2021."},{"issue":"6","key":"i1062-6050-59-4-373-b07","series-title":"JAMA Neurol","first-page":"697","article-title":"Prevalence of invalid performance on baseline testing for sport-related concussion by age and validity indicator","volume":"75","author":"Abeare","year":"2018","unstructured":"Abeare\n CA,\n \n \n Messa\n I,\n \n \n Zuccato\n BG,\n \n \n Merker\n B,\n \n \n Erdodi\n L.\n \n \n Prevalence of invalid performance on baseline testing for sport-related concussion by age and validity indicator\n .\n \n JAMA Neurol\n . 2018;75(6):697\u2013703. doi:10.1001\/jamaneurol.2018.0031"},{"issue":"5","key":"i1062-6050-59-4-373-b08","series-title":"J Int Neuropsychol Soc","first-page":"461","article-title":"Influence of special education, ADHD, autism, and learning disorders on ImPACT validity scores in high school athletes","volume":"27","author":"Maietta","year":"2021","unstructured":"Maietta\n JE,\n \n \n Barchard\n KA,\n \n \n Kuwabara\n HC,\n \n et al.\n\n Influence of special education, ADHD, autism, and learning disorders on ImPACT validity scores in high school athletes. J Int Neuropsychol Soc. 2021;27(5):461\u2013471. doi:10.1017\/S1355617720001149"},{"issue":"8","key":"i1062-6050-59-4-373-b09","series-title":"Am J Sports Med","first-page":"2018","article-title":"Rates and predictors of invalid baseline test performance in high school and collegiate athletes for 3 computerized neurocognitive tests: ANAM, Axon Sports, and ImPACT","volume":"43","author":"Nelson","year":"2015","unstructured":"Nelson\n LD,\n \n \n Pfaller\n AY,\n \n \n Rein\n LE,\n \n \n McCrea\n MA.\n \n \n Rates and predictors of invalid baseline test performance in high school and collegiate athletes for 3 computerized neurocognitive tests: ANAM, Axon Sports, and ImPACT. Am J Sports Med. 2015;43(8):2018\u20132026. doi:10.1177\/0363546515587714"},{"issue":"4","key":"i1062-6050-59-4-373-b10","series-title":"J Clin Transl Res","first-page":"168","article-title":"Socioeconomic status and race as social determinants of health to be considered in clinical use of pre-season vestibular and oculomotor tests for concussion","volume":"6","author":"Wallace","year":"2020","unstructured":"Wallace\n J,\n \n \n Worts\n P,\n \n \n Moran\n R,\n \n et al.\n\n Socioeconomic status and race as social determinants of health to be considered in clinical use of pre-season vestibular and oculomotor tests for concussion. J Clin Transl Res. 2020;6(4):168\u2013178. doi:10.18053\/Jctres\/06.202005.002"},{"issue":"2","key":"i1062-6050-59-4-373-b11","series-title":"Concussion","first-page":"CNC8","article-title":"The King-Devick test of rapid number naming for concussion detection: meta-analysis and systematic review of the literature","volume":"1","author":"Galetta","year":"2015","unstructured":"Galetta\n KM,\n \n \n Liu\n M,\n \n \n Leong\n DF,\n \n \n Ventura\n RE,\n \n \n Galetta\n SL,\n \n \n Balcer\n LJ.\n \n \n The King-Devick test of rapid number naming for concussion detection: meta-analysis and systematic review of the literature. Concussion. 2015;1(2):CNC8. doi:10.2217\/cnc.15.8"},{"issue":"1","key":"i1062-6050-59-4-373-b12","series-title":"Psychopharmacology (Berl","first-page":"55","article-title":"Effects of early life stress on cognitive and affective function: an integrated review of human literature","volume":"214","author":"Pechtel","year":"2011","unstructured":"Pechtel\n P,\n \n \n Pizzagalli\n DA.\n \n \n Effects of early life stress on cognitive and affective function: an integrated review of human literature. Psychopharmacology (Berl).2011;214(1):55\u201370. doi:10.1007\/s00213-010-2009-2"},{"issue":"6","key":"i1062-6050-59-4-373-b13","series-title":"Depress Anxiety","first-page":"514","article-title":"Posttraumatic stress symptoms and brain function during a response-inhibition task: an fMRI study in youth","volume":"25","author":"Carrion","year":"2008","unstructured":"Carrion\n VG,\n \n \n Garrett\n A,\n \n \n Menon\n V,\n \n \n Weems\n CF,\n \n \n Reiss\n AL.\n \n \n Posttraumatic stress symptoms and brain function during a response-inhibition task: an fMRI study in youth. Depress Anxiety. 2008;25(6):514\u2013526. doi:10.1002\/da.20346"},{"issue":"5","key":"i1062-6050-59-4-373-b14","series-title":"J Abnorm Child Psychol","first-page":"935","article-title":"Neighborhood deprivation during early childhood and conduct problems in middle childhood: mediation by aggressive response generation","volume":"45","author":"Gal\u00e1n","year":"2017","unstructured":"Gal\u00e1n\n CA,\n \n \n Shaw\n DS,\n \n \n Dishion\n TJ,\n \n \n Wilson\n MN.\n \n \n Neighborhood deprivation during early childhood and conduct problems in middle childhood: mediation by aggressive response generation. J Abnorm Child Psychol. 2017;45(5):935\u2013946. doi:10.1007\/s10802-016-0209-x"},{"issue":"9","key":"i1062-6050-59-4-373-b15","series-title":"J Youth Adolesc","first-page":"1891","article-title":"Being poorer than the rest of the neighborhood: relative deprivation and problem behavior of youth","volume":"46","author":"Nieuwenhuis","year":"2017","unstructured":"Nieuwenhuis\n J,\n \n \n van Ham\n M,\n \n \n Yu\n R,\n \n \n Branje\n S,\n \n \n Meeus\n W,\n \n \n Hooimeijer\n P.\n \n \n Being poorer than the rest of the neighborhood: relative deprivation and problem behavior of youth. J Youth Adolesc. 2017;46(9):1891\u20131904. doi:10.1007\/s10964-017-0668-6"},{"issue":"suppl 1","key":"i1062-6050-59-4-373-b16","series-title":"J Gerontol B Psychol Sci Soc Sci","first-page":"S51","article-title":"The effect of childhood socioeconomic position and social mobility on cognitive function and change among older adults: a comparison between the United States and England","volume":"76","author":"Faul","year":"2021","unstructured":"Faul\n JD,\n \n \n Ware\n EB,\n \n \n Kabeto\n MU,\n \n \n Fisher\n J,\n \n \n Langa\n KM.\n \n \n The effect of childhood socioeconomic position and social mobility on cognitive function and change among older adults: a comparison between the United States and England. J Gerontol B Psychol Sci Soc Sci. 2021;76(suppl 1):S51\u2013S63. doi:10.1093\/geronb\/gbaa138"},{"issue":"8","key":"i1062-6050-59-4-373-b17","series-title":"PLoS One","first-page":"e0254414","article-title":"Socioeconomic position, social mobility, and health selection effects on allostatic load in the United States","volume":"16","author":"Gugushvili","year":"2021","unstructured":"Gugushvili\n A,\n \n \n Bulczak\n G,\n \n \n Zelinska\n O,\n \n \n Koltai\n J.\n \n \n Socioeconomic position, social mobility, and health selection effects on allostatic load in the United States. PLoS One. 2021;16(8):e0254414. doi:10.1371\/journal.pone.0254414"},{"issue":"5","key":"i1062-6050-59-4-373-b18","series-title":"Public Adm Rev","first-page":"675","article-title":"Leveraging administrative data to better serve children and families","volume":"79","author":"Fischer","year":"2019","unstructured":"Fischer\n RL,\n \n \n Richter\n FG,\n \n \n Anthony\n E,\n \n \n Lalich\n N,\n \n \n Coulton\n C.\n \n \n Leveraging administrative data to better serve children and families. Public Adm Rev. 2019;79(5):675\u2013683. doi:10.1111\/puar.13047"},{"article-title":"2015 area deprivation index v3.1","author":"Neighborhood Atlas","key":"i1062-6050-59-4-373-b19","unstructured":"Neighborhood Atlas\n . 2015 area deprivation index v3.1. University of Wisconsin School of Medicine and Public Health. Accessed October 1, 2021. https:\/\/www.neighborhoodatlas.medicine.wisc.edu"},{"issue":"26","key":"i1062-6050-59-4-373-b20","series-title":"N Engl J Med","first-page":"2456","article-title":"Making neighborhood-disadvantage metrics accessible\u2014the Neighborhood Atlas","volume":"378","author":"Kind","year":"2018","unstructured":"Kind\n AJH,\n \n \n Buckingham\n WR.\n \n \n Making neighborhood-disadvantage metrics accessible\u2014the Neighborhood Atlas. N Engl J Med. 2018;378(26):2456\u20132458. doi:10.1056\/NEJMp1802313"},{"issue":"9","key":"i1062-6050-59-4-373-b21","series-title":"Children (Basel)","first-page":"761","article-title":"Adverse childhood experiences predict common neurodevelopmental and behavioral health conditions among U.S. children","volume":"8","author":"Zarei","year":"2021","unstructured":"Zarei\n K,\n \n \n Xu\n G,\n \n \n Zimmerman\n B,\n \n \n Giannotti\n M,\n \n \n Strathearn\n L.\n \n \n Adverse childhood experiences predict common neurodevelopmental and behavioral health conditions among U.S. children. 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J Athl Train. 2009;44(6):639\u2013644. doi:10.4085\/1062-6050-44.6.639"},{"issue":"1","key":"i1062-6050-59-4-373-b25","series-title":"Clin J Sport Med","first-page":"e40","article-title":"Concussion baseline retesting is necessary when initial scores are low","volume":"32","author":"Fraser","year":"2022","unstructured":"Fraser\n MA,\n \n \n Kilchrist\n LM,\n \n \n Kuo\n M.\n \n \n Concussion baseline retesting is necessary when initial scores are low. Clin J Sport Med. 2022;32(1):e40\u2013e51. doi:10.1097\/JSM.0000000000000872"},{"issue":"7","key":"i1062-6050-59-4-373-b26","series-title":"Med Sci Sports Exerc","first-page":"1377","article-title":"Valid but invalid: suboptimal ImPACT baseline performance in university athletes","volume":"50","author":"Walton","year":"2018","unstructured":"Walton\n SR,\n \n \n Broshek\n DK,\n \n \n Freeman\n JR,\n \n \n Cullum\n CM,\n \n \n Resch\n JE.\n \n \n Valid but invalid: suboptimal ImPACT baseline performance in university athletes. Med Sci Sports Exerc. 2018;50(7):1377\u20131384. doi:10.1249\/MSS.0000000000001592"},{"issue":"4","key":"i1062-6050-59-4-373-b27","series-title":"J Athl Train","first-page":"554","article-title":"Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport, Zurich, November 2012","volume":"48","author":"McCrory","year":"2013","unstructured":"McCrory\n P,\n \n \n Meeuwisse\n WH,\n \n \n Aubry\n M,\n \n et al.\n\n Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport, Zurich, November 2012. J Athl Train. 2013;48(4):554\u2013575. doi:10.4085\/1062-6050-48.4.05"},{"article-title":"Implicit bias in the child welfare, education and mental health systems","author":"Lee","key":"i1062-6050-59-4-373-b28","unstructured":"Lee\n J,\n \n \n Bell\n Z,\n \n \n Ackerman-Brimberg\n M,\n \n \n Harris\n M,\n \n \n Benton\n H.\n \n \n Implicit bias in the child welfare, education and mental health systems. 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