Preliminary Normative Data on the Penn State University Symbol Cancellation Task With Nonconcussed Adolescents

Visual concentration impairment after neurologic injury is frequent, making its identification a critical component of neurocognitive concussion assessment. Visual target cancellation tests such as the Penn State University Symbol Cancellation Task (PSUSCT) have been widely used in assessing professional and collegiate athletes. To date, there are no normative studies using the PSUSCT with an adolescent population. Given that 38 million children and adolescents participate in sports and an estimated 5% to 10% are concussed annually, adolescent normative data are critically needed to evaluate concussions in this vulnerable population. The purpose of this study was to provide adolescent normative data on the PSUSCT. Participants included 40 healthy, nonconcussed high school students aged 14 to 19 years old (20 men, 20 women). Participants were administered Forms A and C of the PSUSCT within a 4-day period. Data analysis examined hits, omission errors, and commission errors, with descriptive statistics calculated for the total sample and for subgroups by gender and age. Study 1 provided normative adolescent data on Form A. Study 2 examined practice effects and established reliable change indexes (RCIs) by comparing results on Forms A and C. Neither Study 1 nor Study 2 demonstrated significant group differences for gender or age. In conclusion, this study presents adolescent normative data, apparent practice effects, and RCIs on the PSUSCT. These norms provide data needed to appropriately include the PSUSCT in baseline and postinjury concussion evaluation batteries with adolescent student-athletes. Findings should be replicated with a larger, more heterogeneous sample.