A-06 Agree to Disagree: Evaluating the Utility of Child and Parent-Reported Symptom Summary Scores on the ImPACT Pediatric

Abstract Objective ImPACT Pediatric is a neurocognitive test used to assess concussion in children ages 5–11. Embedded in the test is a series of yes/no symptom questions, answered by both parents and their child. The purpose of this study was to determine if there was any utility in creating summary scores using child- and parent-reported symptoms, and document agreement between child- and parent-reported symptoms. Method De-identified baseline and post-concussion ImPACT Pediatric data were obtained from the lead programmer at ImPACT Applications, Inc, who was blind to the purpose of the study. Number of symptoms endorsed through parent and child self-report was documented by summing individual symptoms endorsed at baseline and within 7 days of concussion. Chi-squared analyses were conducted to evaluate the level of agreement between the four symptoms that appear on both child and parent symptom lists (Headache, Dizziness, Tiredness, and Nausea/Vomiting). Results Across the four shared symptoms (Headache, Dizziness, Tiredness, and Nausea/Vomiting), parent- child co-endorsement ranged from 27%–71% at baseline, and 69%–95% post-concussion; Kappa (as a measure of agreement) was weak; .24–.41. Paired-samples T-tests revealed children report significantly more symptoms than their parents at baseline (p < .001) but not post-concussion (p = .14). Conclusions Parents and their children are not in agreement with respect to symptom endorsement on the ImPACT Pediatric at baseline, with children endorsing a significantly greater number of total symptoms. While the presence/absence of specific symptoms may be of clinical utility, creating a summary symptom score out of binary symptom data does not appear to be useful.