impact pediatric data clinical report final · • report will provide raw scores for each test and...
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ImPACT Pediatric Data and Clinical ReportPresenter: Jon Almquist, ATC, ITAT
Concussion SpecialistFairfax Family Practice Comprehensive Concussion Clinic
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• The statements and opinions contained in this program are solely those of the presenter.
• Treatment options and tools presented are some of many that are available.
• All individuals in control of content disclosed no relevant financial relationships.
• Other CE disclosures can be found in your course information document.
Disclosure Statements
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This course describes the raw data on the ImPACT Pediatric Clinical report. Attendees will learn how each factor score is calculated and will see an overview of test performance by age. Case studies that illustrate specific aspects of test performance will also be discussed.
Course Objectives: At the end of the course, attendees will be able to:• Restate how to utilize ImPACT Pediatric in a clinical setting for patients
aged 5-11• Identify how to use the ImPACT Pediatric factor scores and raw data to
inform clinical decision making regarding concussed pediatric patients
Course Description
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Speaker Biography
• Was employed for over 30 years in the Fairfax County Public School System as an athletic trainer, teacher, and administrator
• Currently employed by Fairfax Family Practice Comprehensive Concussion Clinic as a Concussion Specialist
• Co-owner of JLA Consulting, LLC
• Co-developer of a software program designed to organize and track concussion education and baseline testing for youth athletic associations
• Inducted into the NATA Hall of Fame, class of 2014
Jon Almquist, ATC, VATLConcussion SpecialistFairfax Family Practice Comprehensive Concussion Clinic
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What is ImPACT Pediatric?
• Computerized cognitive test for ages 5-11
• iPad
• Clinical report
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ImPACT Pediatric is Not
• A stand-alone assessment
• Effective if the clinician is untrained
• A substitute for thorough medical evaluation
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Why ImPACT Pediatric?
• ImPACT: designed for ages 12-59
• Younger children: limited attention spans, require engaging tool
• Younger children: comfortable with touch screen, not with mouse
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ImPACT Pediatric
ImPACT Pediatric was created as a platform to evaluate children between the ages of 5 and 11• 3:50• 3:53 - Principles for development• Must be brief• Must use tablet (iPad) as platform• Must measure aspects of speed and memory• Must be engaging and face valid• Must be reliable across different administrations• Must be “adjustable” (flexible) for different groups
• Intellectual disabilities and other groups
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Key Assumptions
• Test instructions are read to child by examiner
• Test should not be administered in group setting
• Test administrators must be trained
• It is preferable to have parent or other responsible adult in room to provide knowledge of injury
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ImPACT Pediatric
• Designed for sports but has multiple other potential uses (ADD, Epilepsy, Cancer)• Data gathered through multiple centers
Completed Research• Do we see expected performance for age in non-injured children? (developmental
trends)• Is the test reliable across more than one testing?• Does the test measure meaningful cognitive abilities?• Does the test correlate with Paper and Pencil testing?
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Levels of Interpretation
• Symptoms reported by child
• Symptoms reported by adult (parent, coach, etc.)
• Raw scores of each test module
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Levels of Interpretation
Factor scores • Created by comparing each individual to the mean (average) for his/her age group
and creating Standard (T scores).
• These are then averaged to produce the Factor Scores• T scores constructed: 50 is average and each ten point change = a Standard
Deviation.
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Levels of Interpretation
Factor Scores Report• Sequential Memory• Word Memory• Visual Memory• Rapid Processing
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Factor Score Components
Sequential Memory• Memory Touch, Number Correct• Memory Touch Highest Sequence• Memory Touch Sequences Correct
Word Memory• Shopping List Number Correct• Shopping List Number Correct, Delayed
Free Recall• Shopping List Number Correct
Recognition
Visual Memory• Picture Match Average Taps• Picture Match Average Time
Rapid Processing (Reaction Time)• Traffic Light Average Time• Design Rotation Number Correct
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Developmental Data
• Neurological development is rapid in 5-11 age group
• Important to show expected changes in cognition• Cognitive speed improves with age• Memory processes improve with age
• Need “norms” for specific age groups
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ImPACT Pediatric Test Module Overview
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Test Modules:
Word List Design Rotation Stop & Go Memory Touch Picture Match
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Test Modules:
Word List Design Rotation Stop & Go Memory Touch Picture Match
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Word List - Immediate
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Clinical Report pg.3
Word ListSkipped this module No No
Immediate Recall Num. Correct 5 1
Immediate Recall Num. Incorrect 0 2
Immediate Recall Percent Correct 100 20
Delayed Recall Number Correct 5 0
Delayed Recall Number Incorrect 0 2
Delayed Recall Percent Correct 100 0
Del. Recognition Number Correct 7 3Del. Recognition Percent Correct 70 30
Time Between Tests (in seconds) 294.33 342.36
Word Memory
Word Memory
Word Memory
Best 5/5
Best 5/5
Best 10/10Time between end of Immediate Recall to start of Delayed Free
Recall
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Test Performance by Age
Perfect score= 5 (higher score represents better performance)
2.41.95
2.83
3.43.6 3.6
4
1.8
2.3
2.8
3.3
3.8
4.3
4.8
5 6 7 8 9 10 11
Word Memory Immediate Free Recall
WordMemoryImmediate
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Test Performance by Age
Perfect score= 5 (higher score represents better performance)
1.271.23
2.142.53
2.772.76
3.76
1
1.5
2
2.5
3
3.5
4
5 6 7 8 9 10 11
Word Memory Delay
WordMemoryDelay
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Test Performance by Age
Perfect score= 10 (higher score represents better performance)
7.958.15
8.57
8.88 8.96
9.1 9.35
7
7.5
8
8.5
9
9.5
5 6 7 8 9 10 11
Word Memory Recognition
WordMemoryRecognition
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Test Modules:
Word List Design Rotation Stop & Go Memory Touch Picture Match
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Design Rotation
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Clinical Report pg.3
Design RotationSkipped this module No No
Number Correct 10 10Percent Correct 100 100
Average Time (in seconds) 1.47 1.86
Rapid Processing
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Test Performance by Age
A lower score represents better (faster) performance.
3.7
3.142.96
2.822.59
2.49
2.122
2.5
3
3.5
4
5 6 7 8 9 10 11
Design Rotation Average Time
DesignRotationAverageTime
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Word List Design Rotation Stop & Go Memory Touch Picture Match
Test Modules:
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Stop and Go (The Traffic Light Test)
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Clinical Report pg.4
Stop & GoSkipped this module No No
Number Correct 10 10
Average Correct Answer Time 0.62 1.05
Number Incorrect Red Lights 0 0
Number Incorrect Green Lights 0 0
Number Incorrect Yellow Lights 0 2
Number of Omissions 0 0
Rapid Processing
Best of 10/10
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Test Performance by Age
A lower score represents better performance.
10.991
0.99
0.96
0.93
0.95
0.97
0.88
0.9
0.92
0.94
0.96
0.98
1
1.02
5 6 7 8 9 10 11
Stop and Go Average Time
Stop andGoAverageTime
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Word List Design Rotation Stop & Go Memory Touch Picture Match
Test Modules:
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Memory Touch
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Clinical Report pg.5
Memory TouchSkipped this module No No
Number of Sequences Correct 6 3
Number of Stages Correct 3 1
Highest Sequence Reached 5 4
Sequential Memory
Sequential Memory
Sequential Memory
14 Possible
7 Possible
7 Possible
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Test Performance by Age
A higher score represents better performance.
4.37
5.375.82
6.83
7.427.8
44.5
55.5
66.5
77.5
8
5 6 7 8 9 10 11
Memory Touch Total Correct
MemoryTouch TotalCorrect
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Test Modules:
Word List Design Rotation Stop & Go Memory Touch Picture Match
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Picture Match
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Picture Match
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Clinical Report pg.5
Picture MatchSkipped this module No No
Immediate Memory Averag. Time 30.15 47.7
Immediate Memory Averag. Taps 37 49
Del. Recognition Number Correct 16 11
Del. Recognition Percent Correct 100 69%
Time Between Tests (in seconds) 36.04 32.65
Visual Memory
Visual Memory
Time between end of Picture test to start of Delayed Recognition (Del. Word
Free & Recognition in between)
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Test Performance by Age
A lower score represents better performance.
36.87
37.93
36.35
36.7
36.0
35.6
35.96
3434.535
35.536
36.537
37.538
38.5
5 6 7 8 9 10 11
Picture Match Average Taps
PictureMatchAverageTaps
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Test Performance by Age
A lower score represents better performance.
39.5
41.1
36.8 36.1
33.832.0
29.1
25
30
35
40
45
5 6 7 8 9 10 11
Picture Match Time
PictureMatchTime
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Factor (Composite) Scores
• Based on factor analysis• Report will provide raw scores for each test and standard (T) scores with a mean of 50
and a standard deviation of 10
T=30
T=40
T=50
T=60
T=70
Average25th-75th
Very Superior/Superior9
2th-99th
High Average76th-91st
Borderline Impaired 2nd – 8th
Low Average9th-24th
Impaired < 2nd
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Reliable Change Index Scores (RCI)
• Statistically calculated and based on standard error of measurement
• Allow for “wiggle room” within normal range of scores
• In the non-concussed population, these levels of change would not be exceeded 90% of the time
• Each composite score that is a clinical scale has a unique, corresponding reliable change index score
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How Factor Scores are CalculatedCalculation of T and Factor ScoresTo allow comparison of the subscale module scores to each other on a common metric, these scores were converted to T (transformed) scores.
T ScoresThe raw scores for each ImPACT Pediatric test modules were transformed into non-normalized linear T scores (i.e., M = 50, SD = 10) using the formula described below. This was completed by creating standardized (z) scores for each module and for every age group (5 to 11 years). Z scores have a mean of 0 and a standard deviation of 1 and were calculated by subtracting the individual test score from the group mean and dividing by the standard deviation of the group. The scores for each factor were combined to yield average scores and these were converted to T scores with a mean of 50 and a standard deviation of 10 utilizing the following formula:
T Score Formula: T = (z *10) + 50
Where z represents the standard score, 10, the standard deviation and 50 representing a constant.The advantage of this type of transformation is that it does not alter the shape of the distribution. Any skew that is evident in the raw score distribution is preserved in the T score distribution (Crocker & Algina, 1986). Additionally, the transformation into T scores helps clinical interpretation of data and facilitates explanation by the healthcare professional to parents, coaches and other laypersons.
VariableLeptokurtic / Positively
SkewedSkewness Kurtosis Kolmogorov-
SmirnovPicture Match Time 0.69 0.20 <.001
Picture Match Taps 0.69 0.32 <.001
Design Rotation Average Time 0.82 1.09 <.001
Leptokurtic / NegativelySkewed
Stop And Go Average Time 0.53 -0.07 <.001
Platykurtic / Positively Skewed
Memory Touch Total Correct -0.24 0.13 <.001
Memory Touch HighestSequence
-0.48 0.25 <.001
Word Memory Recognition -1.21 0.81 <.001
Platykurtic / Negatively Skewed
Memory Touch SequencesCorrect
-0.11 -0.33 <.001
Word Memory Delayed -0.18 -0.88 <.001
Word Memory Immediate -0.65 -0.46 <.001
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Potential Errors for Each Factor Score- Contributions to this Error
Examiner Error- Failed to present stimuli correctly (e.g. misreading instructions to child)- Doesn’t follow directions in giving test
Subject Error- Child doesn’t understand direction (make sure child can do samples before progressing)- Child is tired or uncooperative- Attempts to fake the test (sandbagging is rare in young children but can happen)
Test Error- iPad not functioning properly - App won’t load correctly
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Test Invalidity
• Child Did Not Understand Directions- Solution: Make sure child can complete before progressing
• Improper Administration- Solution: Make sure that you understand administration
Test may be invalid if any of the following scores:• Word Memory recognition < 5• Design Rotation average time > 5 seconds or number correct< 5• Memory touch sequences correct < 2 • Picture Match average taps > 50 or completion time > 60• Stop and Go average time > 5 seconds or number correct <5
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ImPACT Pediatric Clinical Report
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Factor ScoresSequential Memory 44 31 Score is > 2 SDs below Average
Word Memory 50 20 Score is 3 > SDs below Average
Visual Memory 50 26 Score is 2.5 > SDs below Average
Rapid Processing 66 47 Score is almost 2 SDs below Baseline
Pediatric Clinical Report pg.1
GeneralTest Type Baseline Post-Injury
Test Battery Pediatric PediatricAge When Tested 10 10
Test Date and Time 03/07/2015 11:18 AM 03/07/2015 11:34 AMInjury Date and Time 03/07/2015 11:34 AM
Parent/Guardian Present True TrueTest Language English English
Test Administrator Demo4 Demo4Test Version 1.0.0 1.0.0
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Pediatric Clinical Report pg.1Demographics
Diagnosed Concussions 0 1
Unconscious After Head Injury No No
Repeated a Grade in School No No
Skipped a Grade in School No No
In Kindergarten No No
Diagnosed with Seizures No No
Diagnosed with ADD or ADHD No No
Diagnosed with Dyslexia No No
Other Learning Disability No No
Diagnosed with Autism Disorder No No
Diagnosed with Speech Problems No No
Diagnosed with Vision Problems No No
Diagnosed with Hearing Problems No No
Diagnosed with Depression No No
Diagnosed with Anxiety No No
Other Diagnoses
Medications
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Symptom Reporting by Child and Adult
Sympt. Reported by Test Taker
Headache No YesStomach Ache No Yes
Dizziness No YesFeeling Tired No Yes
Reading Problems No YesTV/Computer Problems No No
Light Sensitivity No NoNoise Sensitivity No No
Fuzzy Vision No NoCar Sickness No No
Memory Problems No NoOther Symptoms Reported
Sympt. Reported by Parent
Headache No YesNausea No Yes
Vomiting No NoDizziness No Yes
Balance Problems No YesIrritability No Yes
Fatigue No YesSleeping More No YesSleeping Less No No
Morning/Afternoon Difference
No Yes
Anxiety No NoOther Symptoms Reported
Pediatric Clinical Report pg.2
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Word ListSkipped this module No No
Immediate Recall Num. Correct 5 1Immediate Recall Num. Incorrect 0 2Immediate Recall Percent Correct 100 20
Delayed Recall Number Correct 4 0Delayed Recall Number Incorrect 0 2
Delayed Recall Percent Correct 100 20Del. Recognition Number Correct 7 3Del. Recognition Percent Correct 70 30Time Between Tests (in seconds) 294.33 342.36
Design RotationSkipped this module No No
Number Correct 10 10Percent Correct 100 100
Average Time (in seconds) 1.47 1.86Stop & Go
Skipped this module No NoNumber Correct 10 10
Average Correct Answer Time 0.62 1.05Number Incorrect Red Lights 0 0
Number Incorrect Green Lights 0 0Number Incorrect Yellow Lights 0 2
Number of Omissions 0 0
Pediatric Clinical Report pg.3
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Memory TouchSkipped this module No No
Number of Sequences Correct 6 3Number of Stages Correct 3 1Highest Sequence Reached 5 4
Picture MatchSkipped this module No No
Immediate Memory Averag. Time 30.15 47.7Immediate Memory Averag. Taps 37 49Del. Recognition Number Correct 16 11Del. Recognition Percent Correct 100% 69%Time Between Tests (in seconds) 36.04 32.65
Pediatric Clinical Report pg.4
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ImPACT Pediatric Case Studies
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CASE STUDY #1
9 Year Old Female Ice Hockey Player• Fell to ice, struck side of head on ice• Sideline test administered• Immediate removal from ice
• Headache minor lasting few hours• Seen in clinic next day• No symptom increase at school
Clinic Evaluation• VOMS – unremarkable
• Slight dizziness with VOR
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Factor ScoresSequential Memory 64 55
Word Memory 57 50Visual Memory 57 49
Rapid Processing 62 60
CASE STUDY #1
Pediatric Clinical Report pg.1 (9yo w/baseline)
GeneralTest Type Baseline Post-Injury
Test Battery Pediatric PediatricAge When Tested 9 9
Test Date and Time 08/26/2017 11:18 AM 10/02/2017 11:34 AMInjury Date and Time 10/01/2017 11:34 AM
Parent/Guardian Present True TrueTest Language English English
Test Administrator ET ETTest Version 1.1.0 1.1.0
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DemographicsDiagnosed Concussions 0 0
Unconscious After Head Injury No NoRepeated a Grade in School No NoSkipped a Grade in School No No
In Kindergarten No NoDiagnosed with Seizures No No
Diagnosed with ADD or ADHD No NoDiagnosed with Dyslexia No NoOther Learning Disability No No
Diagnosed with Autism Disorder No NoDiagnosed with Speech Problems No NoDiagnosed with Vision Problems No No
Diagnosed with Hearing Problems No NoDiagnosed with Depression No No
Diagnosed with Anxiety No NoOther Diagnoses
Medications
CASE STUDY #1Pediatric Clinical Report pg.1 (9yo w/baseline)
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Symptom reporting by Adult is often different than child
Symptom Reporting by Child and AdultSymptoms Reported by Test Taker
BL PI 1
Headache No YesStomach Ache No Yes
Dizziness No YesFeeling Tired No Yes
Reading Problems No YesTV/Computer Problems No No
Light Sensitivity No NoNoise Sensitivity No No
Fuzzy Vision No NoCar Sickness No No
Memory Problems No NoOther Symptoms Reported
Symptoms Reported by Parent
BL PI 1
Headache No YesNausea No Yes
Vomiting No NoDizziness No Yes
Balance Problems No YesIrritability No Yes
Fatigue No YesSleeping More No YesSleeping Less No No
Morning/Afternoon Difference No YesAnxiety No No
Other Symptoms Reported
CASE STUDY #1 Pediatric Clinical Report pg.2 (9yo w/baseline)
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Word ListSkipped this module No No
Immediate Recall Num. Correct 4 4Immediate Recall Num. Incorrect 0 2Immediate Recall Percent Correct 80% 80%
Delayed Recall Number Correct 4 3Delayed Recall Number Incorrect 0 0
Delayed Recall Percent Correct 100 20Del. Recognition Number Correct 10 8Del. Recognition Percent Correct 100% 80%Time Between Tests (in seconds) 599.85 427.68
Design RotationSkipped this module No No
Number Correct 10 10Percent Correct 100% 100%
Average Time (in seconds) 1.68 1.64Stop & Go
Skipped this module No NoNumber Correct 10 10
Average Correct Answer Time 0.66 0.70Number Incorrect Red Lights 0 0
Number Incorrect Green Lights 0 0Number Incorrect Yellow Lights 0 0
Number of Omissions 0 0
CASE STUDY #1Pediatric Clinical Report pg.3 (9yo w/baseline)
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Memory TouchSkipped this module No No
Number of Sequences Correct 10 8Number of Stages Correct 5 3Highest Sequence Reached 7 7
Picture MatchSkipped this module No No
Immediate Memory Averag. Time 29.59 28.06Immediate Memory Averag. Taps 33 34Del. Recognition Number Correct 15 15Del. Recognition Percent Correct 93.75% 93.75%Time Between Tests (in seconds) 116.43 86.64
CASE STUDY #1Pediatric Clinical Report pg.4 (9yo w/baseline)
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Factor ScoresSequential Memory 64 55 69
Word Memory 57 50 55Visual Memory 57 49 57
Rapid Processing 62 60 63
CASE STUDY #1Pediatric Clinical Report pg.1 (9yo w/baseline)
General
Test Type Baseline Post-Injury 1 Post-Injury 2Test Battery Pediatric Pediatric Pediatric
Age When Tested 9 9 9Test Date and Time 08/26/2017 11:18 AM 10/02/2017 11:34 AM 10/5/2017 5:10 PM
Injury Date and Time 10/01/2017 11:34 AM 10/01/2017 11:34 AMParent/Guardian Present True True True
Test Language English English EnglishTest Administrator ET ET ET
Test Version 1.1.0 1.1.0 1.1.0
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Demographics Baseline Post-1 Post-2
Diagnosed Concussions 0 0 0
Unconscious After Head Injury No No No
Repeated a Grade in School No No No
Skipped a Grade in School No No No
In Kindergarten No No No
Diagnosed with Seizures No No No
Diagnosed with ADD or ADHD No No No
Diagnosed with Dyslexia No No No
Other Learning Disability No No No
Diagnosed with Autism Disorder No No No
Diagnosed with Speech Problems No No No
Diagnosed with Vision Problems No No No
Diagnosed with Hearing Problems No No No
Diagnosed with Depression No No No
Diagnosed with Anxiety No No No
Other Diagnoses
Medications
CASE STUDY #1Pediatric Clinical Report pg.1 (9yo w/baseline)
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Symptom reporting by Adult is often different than child
Symptom Reporting by Child and Adult
Symptoms Reported by Test Taker
BL PI 1 PI 2
Headache No Yes NoStomach Ache No Yes No
Dizziness No Yes NoFeeling Tired No Yes No
Reading Problems No Yes NoTV/Computer Problems No No No
Light Sensitivity No No NoNoise Sensitivity No No No
Fuzzy Vision No No NoCar Sickness No No No
Memory Problems No No NoOther Symptoms Reported
Symptoms Reported by Parent
BL PI 1 PI 2
Headache No Yes NoNausea No Yes No
Vomiting No No NoDizziness No Yes No
Balance Problems No Yes NoIrritability No Yes No
Fatigue No Yes NoSleeping More No Yes NoSleeping Less No No No
Morning/Afternoon Difference No Yes NoAnxiety No No No
Other Symptoms Reported
CASE STUDY #1Pediatric Clinical Report pg.2 (9yo w/baseline)
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Word ListSkipped this module No No No
Immediate Recall Num. Correct 4 4 5Immediate Recall Num. Incorrect 0 2 0Immediate Recall Percent Correct 80% 80% 100%
Delayed Recall Number Correct 4 3 3Delayed Recall Number Incorrect 0 0 0
Delayed Recall Percent Correct 100 20 60%Del. Recognition Number Correct 10 8 9Del. Recognition Percent Correct 100% 80% 90%Time Between Tests (in seconds) 599.85 427.68 435.40
Design RotationSkipped this module No No No
Number Correct 10 10 10Percent Correct 100% 100% 100%
Average Time (in seconds) 1.68 1.64 1.19Stop & Go
Skipped this module No No NoNumber Correct 10 10 10
Average Correct Answer Time 0.66 .70 0.69Number Incorrect Red Lights 0 0 0
Number Incorrect Green Lights 0 0 0Number Incorrect Yellow Lights 0 0 0
Number of Omissions 0 0 0
CASE STUDY #1Pediatric Clinical Report pg.3 (9yo w/baseline)
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Memory TouchSkipped this module No No No
Number of Sequences Correct 10 8 11
Number of Stages Correct 5 3 5
Highest Sequence Reached 7 7 8
Picture MatchSkipped this module No No No
Immediate Memory Averag. Time 29.59 28.06 28.65
Immediate Memory Averag. Taps 33 34 41
Del. Recognition Number Correct 15 15 16
Del. Recognition Percent Correct 93.75% 93.75% 100%
Time Between Tests (in seconds) 116.43 86.64 67.45
CASE STUDY #1Pediatric Clinical Report pg.4 (9yo w/baseline)
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CASE STUDY #2
7 Year Old Male (non-athlete)• Playing with brother, hit in head • No loss of consciousness• Remained playing
• Complained of HA later• Teacher noticed changes, slowed,
less active• Decreased attention span• Worse at end of day
• Clinic Evaluation• VOMS = Increased headache and
dizziness with pursuits and VOR• NPC = WNL• VMS = dizziness• No diagnosis of ADHD• Presented with minimal parental
disciplinary intervention
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Factor ScoresSequential Memory 32
Word Memory 56Visual Memory 52
Rapid Processing 78
CASE STUDY #2 Pediatric Clinical Report pg.1 (7 yo NO BASELINE)
GeneralTest Type Post-Injury
Test Battery PediatricAge When Tested 7
Test Date and Time 03/23/2017 11:18 AMInjury Date and Time 03/21/2017 11:34 AM
Parent/Guardian Present TrueTest Language English
Test Administrator JATest Version 1.1.0
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DemographicsDiagnosed Concussions 0
Unconscious After Head Injury NoRepeated a Grade in School NoSkipped a Grade in School No
In Kindergarten NoDiagnosed with Seizures No
Diagnosed with ADD or ADHD NoDiagnosed with Dyslexia NoOther Learning Disability No
Diagnosed with Autism Disorder NoDiagnosed with Speech Problems NoDiagnosed with Vision Problems No
Diagnosed with Hearing Problems NoDiagnosed with Depression No
Diagnosed with Anxiety NoOther Diagnoses
Medications
CASE STUDY #2 Pediatric Clinical Report pg.1 (7 yo NO BASELINE)
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Symptom reporting by Adult may be different than child
Symptom Reporting by Child and Adult
Sympt. Reported by Test Taker
Headache YesStomach Ache No
Dizziness NoFeeling Tired Yes
Reading Problems NoTV/Computer Problems No
Light Sensitivity YesNoise Sensitivity Yes
Fuzzy Vision NoCar Sickness No
Memory Problems YesOther Symptoms
Reported
Sympt. Reported by Parent
Headache YesNausea No
Vomiting NoDizziness Yes
Balance Problems YesIrritability No
Fatigue YesSleeping More YesSleeping Less No
Morning/Afternoon Difference
No
Anxiety NoOther Symptoms Reported
CASE STUDY #2Pediatric Clinical Report pg.2 (7 yo NO BASELINE)
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Word ListSkipped this module No
Immediate Recall Num. Correct 3Immediate Recall Num. Incorrect 0Immediate Recall Percent Correct 60%
Delayed Recall Number Correct 3Delayed Recall Number Incorrect 0
Delayed Recall Percent Correct 60%Del. Recognition Number Correct 10Del. Recognition Percent Correct 100%Time Between Tests (in seconds) 360.87
Design RotationSkipped this module No
Number Correct 8Percent Correct 80%
Average Time (in seconds) 1.65Stop & GoSkipped this module No
Number Correct 10Average Correct Answer Time 0.66Number Incorrect Red Lights 0
Number Incorrect Green Lights 0Number Incorrect Yellow Lights 0
Number of Omissions 0
CASE STUDY #2 Pediatric Clinical Report pg.3 (7 yo NO BASELINE)
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Memory TouchSkipped this module No
Number of Sequences Correct 1Number of Stages Correct 0Highest Sequence Reached 3
Picture MatchSkipped this module No
Immediate Memory Averag. Time 29.06Immediate Memory Averag. Taps 41Del. Recognition Number Correct 16Del. Recognition Percent Correct 93.75%Time Between Tests (in seconds) 61.42
CASE STUDY #2Pediatric Clinical Report pg.4 (7 yo NO BASELINE)
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CASE STUDY #2 PLAN
Return to Learn• Partial school day with modifications• Avoid Physical Education and other “Specials”• Allow rest on desk as needed• Modify activity during recess
Physical Activity• Walk, light play, stay in control of symptoms
Home• Minimize screen use, rest as needed
Vestibular-Ocular Reconditioning• Smooth Pursuits• Gaze Stability
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Factor ScoresSequential Memory 32 36
Word Memory 56 65Visual Memory 52 35
Rapid Processing 78 75
CASE STUDY #2Pediatric Clinical Report pg.1 (7 yo NO BASELINE)
GeneralTest Type Post-Injury 1 Post-Injury 2
Test Battery Pediatric PediatricAge When Tested 7 7
Test Date and Time 03/23/2017 11:18 AM 04/5/2017 2:34 PMInjury Date and Time 03/21/2017 11:34 AM 03/21/2017 11:34 AM
Parent/Guardian Present True TrueTest Language English English
Test Administrator JA JATest Version 1.1.0 1.1.0
ConcussionManagement.com Copyright 2018. ImPACT Applications, Inc. All rights reserved.
Word ListSkipped this module No No
Immediate Recall Num. Correct 3 5Immediate Recall Num. Incorrect 0 0Immediate Recall Percent Correct 60% 100%
Delayed Recall Number Correct 3 5Delayed Recall Number Incorrect 0 0
Delayed Recall Percent Correct 60% 100%Del. Recognition Number Correct 10 10Del. Recognition Percent Correct 100% 100%Time Between Tests (in seconds) 360.87313.20
Design RotationSkipped this module No No
Number Correct 8 10Percent Correct 80% 100%
Average Time (in seconds) 1.65 1.54Stop & GoSkipped this module No No
Number Correct 10 10Average Correct Answer Time 0.66 0.75Number Incorrect Red Lights 0 0
Number Incorrect Green Lights 0 0Number Incorrect Yellow Lights 0 2
Number of Omissions 0 0
CASE STUDY #2Pediatric Clinical Report pg.3 (7 yo NO BASELINE)
ConcussionManagement.com Copyright 2018. ImPACT Applications, Inc. All rights reserved.
Memory TouchSkipped this module No No
Number of Sequences Correct 1 2Number of Stages Correct 0 1Highest Sequence Reached 3 3
Picture MatchSkipped this module No No
Immediate Memory Averag. Time 29.06 37.80Immediate Memory Averag. Taps 41 51Del. Recognition Number Correct 16 12Del. Recognition Percent Correct 93.75% 75%Time Between Tests (in seconds) 61.42 54.76
CASE STUDY #2Pediatric Clinical Report pg.4 (7 yo NO BASELINE)
ConcussionManagement.com Copyright 2018. ImPACT Applications, Inc. All rights reserved.
Factor ScoresSequential Memory 32 36 44 52
Word Memory 56 65 49 60Visual Memory 52 35 44 50
Rapid Processing 78 75 59 75
CASE STUDY #2Pediatric Clinical Report pg.1 (7 yo NO BASELINE)
GeneralTest Type Post-Injury 1 Post-Injury 2 Post-Injury 3 Post-Injury 4
Test Battery Pediatric Pediatric Pediatric PediatricAge When Tested 7 7 7 7
Test Date and Time 03/23/2017 11:18 AM 04/5/2017 2:34 PM 04/20/2017 11:27 AM 05/10/2017 9:44 AMInjury Date and Time 03/21/2017 11:34 AM 03/21/2017 11:34 AM 03/21/2017 11:34 AM03/21/2017 11:34 AM
Parent/Guardian Present True True True TrueTest Language English English English English
Test Administrator JA JA JA JATest Version 1.1.0 1.1.0 1.1.0 1.1.0
ConcussionManagement.com Copyright 2018. ImPACT Applications, Inc. All rights reserved.
Word ListSkipped this module No No No No
Immediate Recall Num. Correct 3 5 3 5Immediate Recall Num. Incorrect 0 0 1 0Immediate Recall Percent Correct 60% 100% 60% 100%
Delayed Recall Number Correct 3 5 3 3Delayed Recall Number Incorrect 0 0 0 0
Delayed Recall Percent Correct 60% 100% 70% 100%Del. Recognition Number Correct 10 10 7 10Del. Recognition Percent Correct 100% 100% 70% 100%Time Between Tests (in seconds) 360.87313.20 336.50 367.76
Design RotationSkipped this module No No No No
Number Correct 8 10 10 8Percent Correct 80% 100% 100% 80%
Average Time (in seconds) 1.65 1.54 1.43 1.27Stop & GoSkipped this module No No No No
Number Correct 10 10 9 10Average Correct Answer Time 0.66 0.75 0.92 0.70Number Incorrect Red Lights 0 0 0 0
Number Incorrect Green Lights 0 0 1 0Number Incorrect Yellow Lights 0 2 0 0
Number of Omissions 0 0 0 0
CASE STUDY #2Pediatric Clinical Report pg.3 (7 yo NO BASELINE)
ConcussionManagement.com Copyright 2018. ImPACT Applications, Inc. All rights reserved.
Memory TouchSkipped this module No No No No
Number of Sequences Correct 1 2 4 6Number of Stages Correct 0 1 2 2Highest Sequence Reached 3 3 4 6
Picture MatchSkipped this module No No No No
Immediate Memory Averag. Time 29.06 37.80 32.12 28.89Immediate Memory Averag. Taps 41 51 46 42Del. Recognition Number Correct 16 12 15 16Del. Recognition Percent Correct 93.75% 75% 93.75% 100%Time Between Tests (in seconds) 61.42 54.76 65.67 60.36
CASE STUDY #2Pediatric Clinical Report pg.4 (7 yo NO BASELINE)
ConcussionManagement.com Copyright 2018. ImPACT Applications, Inc. All rights reserved.
In Summary:
• Testing Children is Individual – requires specific knowledge of children and how they react to situations
• When administered appropriately - it is a reliable and valid indicator
• Is a tool and should be use as part of the full evaluation
ConcussionManagement.com Copyright 2018. ImPACT Applications, Inc. All rights reserved.
Thank You!
• For more info, visit our website ImPACTPediatric.com
• Follow Us on Social Media
• Email questions to info@impacttest.com
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