Objective To measure the ultra-acute effects of sport-related concussion in children using the Child SCAT5.

Design A within-subjects prospective study comparing baseline preseason Child SCAT5 scores to post-injury scores obtained immediately following injury on the sideline. Certified athletic trainers administered the Child SCAT5 during baseline preseason assessments and on the sideline following a sport-related concussion.

Setting Middle school sports within a large public-school division in Virginia, USA participating in the George Mason University’s Advancing Healthcare Initiatives for Underserved Students (ACHIEVES) Project.

Participants Forty-two middle school age children (ages 11–13, M=12.5, SD=0.7; 38.1% girls, 61.9% boys).

Outcome Measures The Child SCAT5 is comprised of the following scores: Symptoms; Symptom Severity; Standardized Assessment of Concussion-Child Version (SAC-C), including immediate memory, digits backwards, concentration, and delayed recall; and the Modified Balance Error Scoring System (mBESS).

Main Results Children endorsed more symptoms [baseline: Mean=6.5±6.2 vs. post-injury: 9.1±5.7; p=.01, effect size (r)=-.43] and greater symptom severity [10.0±10.6 vs. 14.7±12.3; p=.01, r=-.39] acutely following injury. They also performed worse on the mBESS following injury [total errors: 5.8±3.8 vs. 8.5±5.4; p=.01, r=-.57, tandem stance: 1.4±1.7 vs. 2.5±2.6; p=.01, r=-.53, and single leg stance: 4.6±2.8 vs. 5.8±3.2; p=.01, r=-.51)]. There were no statistically significant differences on any cognitive scores.

Conclusions Immediately following concussion, children endorsed more symptoms, greater symptoms severity, and performed more poorly on the mBESS. They did not perform more poorly on the cognitive testing compared to their preseason baseline scores on the SAC-C.