# Comparison of Urban versus Industry Normative Values of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT™)

## TL;DR

This study shows that urban high school athletes score lower on cognitive tests compared to standard norms, suggesting the need for socioeconomic-specific baselines for concussion assessment.

## Contribution

The study demonstrates that socioeconomic status affects ImPACT™ scores, advocating for SES-specific normative values in concussion evaluation.

## Key findings

- Urban participants scored significantly lower in verbal and visual memory, motor, and reaction time compared to ImPACT™ norms.
- Differences were observed in both 13–15 and 16–18-year-old age groups.
- The findings suggest that using SES-specific norms could improve concussion management in diverse populations.

## Abstract

Concussion baseline testing has been advocated for the assessment of pre-morbid function. When individual baseline scores are unavailable, utilizing normative values is recommended. However, the validity of generalizing normative data across multiple socioeconomic environments is unknown. Objective: mimic the normative data creation of ImPACT™ to examine the effect of socioeconomic status (SES) on ImPACT™ composite scores. Methods: A retrospective cross-sectional design analyzed completed computerized neuropsychological test data (ImPACT™) obtained to establish the baseline scores of cognitive function from males aged 13–15 years (n = 300) and 16–18 years (n = 331) from an urban high school system. Comparisons between baseline scores and normative ImPACT™ values were calculated utilizing t-tests with ImPACT™ composite scores serving as dependent variables. Results: significant differences between age-dependent urban composite scores and ImPACT™ normative values for 13–15- and 16–18-year-olds were found for Composite Verbal Memory, Composite Visual Memory, Composite Motor and Composite Reaction Time (p < 0.01). Conclusions: Significant differences exist between urban high school athletes and ImPACT™-provided age-dependent normative scores, with urban participants performing below age-dependent normative values. These findings support establishing SES appropriate normative values when baseline test scores are not available for direct comparison in order to provide better evaluation and post-concussion management across diverse populations.