Neurocognitive Performance and Symptom Profiles of Spanish-Speaking Hispanic Athletes on the ImPACT Test

Abstract

This study documented baseline neurocognitive performance of 23,815 athletes on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) test. Specifically, 9,733 Hispanic, Spanish-speaking athletes who completed the ImPACT test in English and 2,087 Hispanic, Spanish-speaking athletes who completed the test in Spanish were compared with 11,955 English-speaking athletes who completed the test in English. Athletes were assigned to age groups (13-15, 16-18). Results revealed a significant effect of language group (p < .001; partial η(2) = 0.06) and age (p < .001; partial η(2) = 0.01) on test performance. Younger athletes performed more poorly than older athletes, and Spanish-speaking athletes completing the test in Spanish scored more poorly than Spanish-speaking and English-speaking athletes completing the test in English, on all Composite scores and Total Symptom scores. Spanish-speaking athletes completing the test in English also performed more poorly than English-speaking athletes completing the test in English on three Composite scores. These differences in performance and reported symptoms highlight the need for caution in interpreting ImPACT test data for Hispanic Americans.

Preseason Baseline Neurocognitive Performances and Symptom Reporting on Immediate Post-Concussion Assessment and Cognitive Testing: A Comparison of Adolescent Student-Athletes Tested in Spanish and English

“…Previous In comparison to previous studies, the magnitude of the effect size differences between participants tested in Spanish versus English was smaller for all neurocognitive composites (see Regarding total symptom reporting, the differences between student-athletes tested in Spanish versus English was significant, but of small magnitude (r=.21). Previous studies 3,8 conducted parametric comparisons on symptom reporting despite a likely skewed distribution.…”

“…These factors can affect performances on cognitive testing in Spanish, and bilingualism specifically has been associated with higher neurocognitive performances on ImPACT® and lower symptom reporting compared to monolingual Spanish speakers. 3 The athletes in our study elected to complete ImPACT® in their preferred language,…”

“…Studies comparing athletes tested in English versus Spanish have found group differences on ImPACT® neurocognitive composites and symptom reporting, with athletes completing the battery in Spanish performing lower on all composites and reporting more baseline symptoms compared to athletes completing the battery in English. 3 A study of professional baseball players found similar results, with players who spoke Spanish as their first language performing lower on all neurocognitive composites compared to players who spoke English as their first language. 8 The reasons for lower performances in athletes tested in Spanish is likely multifaceted and related to factors such as socioeconomic status, 9 acculturative experiences, [10][11][12] and quality of education.…”

“…is commonly used in preseason baseline assessments of athletes who are at risk of experiencing a sport-related concussion. When interpreting post-injury performances on ImPACT®, clinicians must appreciate demographic characteristics and health history variables that may be associated with lower neurocognitive performances or greater symptom reporting prior to a concussion, including age, 1 gender, 2 race/ethnicity, 3,4 attention-deficit disorder (ADD) or attentiondeficit/hyperactivity disorder (ADHD), 5,6 or a history of migraines or mental health problems. 7 Another important consideration is language of administration, especially when performances are compared against English-language ImPACT® normative data.…”

A case matched study examining the reliability of using ImPACT to assess effects of multiple concussions

“…While some concussion research has employed large community-based samples [42], the majority of the published research on concussion and mTBI have used samples of relative small sizes and homogeneous groups. The use of baseline data, rather than post-injury data, in the empirical investigation of concussion-related concepts is also relatively unique in mTBI literature.…”