Nelson Lindsay D, Loman Michelle M, LaRoche Ashley A, Furger Robyn E, McCrea Michael A
Departments of *Neurosurgery; and †Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin.
Clin J Sport Med. 2017 Jul;27(4):381-387. doi: 10.1097/JSM.0000000000000369.
To determine the normative, baseline performance and psychometric properties of the Child Sport Concussion Assessment Tool 3 (Child-SCAT3) in 5- to 13-year-old athletes.
Cross-sectional study.
Practice fields.
Contact sport athletes (N = 155) 5 to 13 years old.
Age, gender, verbal intellectual functioning (receptive vocabulary).
Child-SCAT3: self-reported and parent-reported symptoms, cognitive performance (child form of the Standardized Assessment of Concussion; SAC-C), and balance (modified Balance Error Scoring System, mBESS-C; tandem gait). A subset of the sample repeated the Child-SCAT3 at another date. Some subjects also completed the Adult-SCAT3 version of the symptom checklist and mBESS.
Small-to-medium-sized effects of age were observed on all Child-SCAT3 components. Effects of gender and receptive vocabulary were observed on select components of the SCAT3. Younger age and lower receptive vocabulary were independently associated with greater symptom endorsement, yet parents rated higher symptom burden for older children. Internal consistency reliability and stability of symptom ratings was good to excellent. Stability was more modest for SAC-C and tandem gait scores and very poor for mBESS-C scores, perhaps due to restricted variance. Inter-rater reliability (self-rated vs parent-rated symptoms) was fair.
The Child-SCAT3 self-report symptom checklist may be inappropriate to administer to younger school-aged children. Some of the age effects observed warrant use of demographically appropriate norms in Child-SCAT3 interpretation. The findings can provide guidance for clinicians assessing children of varying ages and point to directions for further development of refined approaches for pediatric concussion assessment.
确定儿童运动性脑震荡评估工具3（Child-SCAT3）在5至13岁运动员中的正常、基线表现及心理测量特性。
横断面研究。
训练场。
5至13岁的接触性运动运动员（N = 155）。
年龄、性别、言语智力功能（接受性词汇）。
Child-SCAT3：自我报告和家长报告的症状、认知表现（儿童版脑震荡标准化评估；SAC-C）以及平衡能力（改良平衡误差评分系统，mBESS-C；串联步态）。样本中的一部分在另一个日期重复进行了Child-SCAT3评估。一些受试者还完成了成人版SCAT3的症状清单和mBESS。
在所有Child-SCAT3组件上均观察到年龄的中小效应。在SCAT3的特定组件上观察到了性别和接受性词汇的效应。年龄较小和接受性词汇较低与更高的症状认可独立相关，但家长对年龄较大儿童的症状负担评分更高。症状评分的内部一致性信度和稳定性良好至优秀。SAC-C和串联步态评分的稳定性较为适中，而mBESS-C评分的稳定性非常差，这可能是由于方差受限所致。评分者间信度（自我评分与家长评分的症状）为中等。
Child-SCAT3自我报告症状清单可能不适用于年幼的学龄儿童。观察到的一些年龄效应表明，在解释Child-SCAT3时应使用符合人口统计学特征的正常标准。这些发现可为评估不同年龄儿童的临床医生提供指导，并为进一步开发精细化的儿科脑震荡评估方法指明方向。
