Objective Examine the effect of athletic participation on ImPACT test scores over time. We hypothesized athletes will score lower than non-athletes over time.

Design Prospective longitudinal between-groups cohort design.

Setting Title 1 school district

Participants High school students (N=783; athletes n=476, non-athletes n=308) were recruited during the academic year and prior to the competitive season to establish baseline cognitive function.

Interventions Annual computerized neuropsychological baseline testing (ImPACT®) was administered to track the effect of cognitive maturity. Composite scores were analyzed with a one-way ANOVA with repeated measures (group x time) using an alpha level of .05 for all tests.

Outcome Measures ImPACT® composite scores.

Main Results Significant interactions of group and time existed for composite visual motor (Wilks’ Lambda = .97, F_(1,782) = 20.53, p < .001, eta squared = .03) between athletes and non-athletes. Significant main effects for time were seen in composite impulse control (Wilks’ Lambda = .99, F_{(1, 782)} = 4.05, p < .05, eta squared = .01.) with lower scores during ninth grade. Significant differences existed between 9^th grade participants and other grades on composite visual motor (p=0.006), and total symptoms (p=0.043) with older participants performing better.

Conclusions Athletic participation does not appear to affect composite ImPACT scores over time, however, ninth grade participants performed worse on composite visual motor and total symptoms. Annual baseline testing may not be warranted beyond tenth grade. Future research should examine the long-term effect of sub concussive hits and low resource environments on cognitive maturity.