Using the SCAT 5 for Diagnosing Concussion in Children

A team of professionals from the medical and athletic communities is working to develop more effective ways for evaluating children who may have suffered a concussion. This effort starts with establishing baselines that are appropriate for different school ages.

Dr. Patricia Kelshaw, PhD, LAT, ATC, and certified athletic trainer is part of this team. She says the team’s starting point is the SCAT 5, or Sport Concussion Assessment Tool. “The SCAT 5 is a standardized tool for evaluating for a suspected concussion and can be used on individuals aged 13 years and older. There has been minimal research on its effectiveness for children, and that’s where we have focused our efforts,” she explains.

Establishing some baselines for pre and post concussive behaviors is important because schools don’t necessarily have an athletic trainer on site. And they may not have an on-staff professional who is trained in assessing possible concussion in children. The intent is that by developing age-appropriate baselines by using the SCAT 5 in elementary and middle schools, concussions will be identified in children in a more timely manner.

“We are developing a better understanding of how children perform when they actually have a concussion versus when they don’t have a concussion, and this may include a cognitive assessment or a balance assessment or a symptom scale, compared with children similar to them. We’re developing normative data for children, using the SCAT Tool, and the norms are tailored to children’s ages in the middle schools, for example, and tailored toward their gender.”

In addition, a unique characteristic of the baseline development is that the team is tailoring some of the baselines toward what language the student primarily speaks. “If you speak Spanish predominantly, and we are giving you an English based cognitive assessment, is that really fair when it comes to a concussion assessment or exam?” says Dr. Kelshaw.

One of the greatest benefits of the SCAT 5 tool is that it is free and easily accessible. It’s important that benchmarks and assessments be modified for use with children. “Children are not miniature adults. We have barely gotten our feet wet in the field of pediatric concussion.”

For more information on traumatic brain injuries, including concussions, contact the Virginia Department of Health at https://www.vdh.virginia.gov/injury-and-violence-prevention/ or the Virginia Concussion Initiative at concussion.gmu.edu.

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