Averaged 22-month test-retest reliability of non-computerized baseline cognitive assessments in healthy youth athletes.

Abstract

Objective: Neuropsychological baseline evaluations in youth are critical in the context of sport concussion management. Youth athletes typically undergo annual baseline evaluations to account for the rapid cognitive development that occurs throughout childhood. However, the reliability of measures used in baseline evaluations at an interval greater than one year is relatively unknown. This study examined the test-retest reliability of non-computerized neuropsychological assessments administered at different time points and aimed to provide neuropsychologists with data to inform their decisions in test selection and clinical interpretation.

Method: Healthy youth male athletes (n = 28, M_age = 11.24 years) completed two comprehensive baseline evaluations on average 22.67 months apart. The intraclass correlation coefficient measured test-retest reliability, and a mixed effects model examined the degree of improvement in test scores and within-subject variability across administrations using both raw and normative scores.

Results: Measures of visuoconstruction, cognitive switching, working memory, contextualized verbal memory, inhibition, and simple attention produced good reliability (>.75), while a measure of visual memory demonstrated poor reliability (<.50) for both normed and raw scores. The authors observed significant interactions between age and time elapsed between baseline administrations for measures of visuoconstruction, visual processing speed, and cognitive switching. Normed scores for measures of working memory, simple attention, and inhibition showed more within-subject variability than raw scores.

Conclusions: All measures, except NEPSY-II Memory for Designs, demonstrated moderate to good test-retest reliability for both absolute and normed scores over an average 22-month interval between baseline administrations. However, clinicians should not overlook potential practice effects when interpreting a youth athlete's second baseline performance. The authors also underscore the value of examining raw data in understanding of cognitive maturation across cognitive domains. Future research should examine the reliability of baseline evaluations incorporating both non-computerized and computerized measures, and replicate findings in a larger sample of youth athletes.