Neurocognitive Concussion Test Performance for Student Athletes on the Autism Spectrum

Area of Science:

• Neuroscience
• Sports Medicine
• Developmental Psychology

Background:

• Adolescent athletes with autism spectrum disorder (ASD) require tailored neurocognitive assessments.
• Understanding baseline functioning is critical for concussion management in this population.
• Academic performance may influence neurocognitive test results.

Purpose of the Study:

• To evaluate baseline neurocognitive functioning in adolescent athletes with ASD.
• To assess the impact of academic performance level on these cognitive functions.
• To compare neurocognitive performance between athletes with ASD and a control group.

Main Methods:

• Cross-sectional, observational study of 6,441 adolescent athletes with self-reported autism.
• Pre-season neurocognitive testing using Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT).
• Inclusion of athletes with and without co-occurring learning disorders (LD) and a control group without ASD or LD.
• Categorization of participants by self-reported academic performance: Average, Above Average, and Below Average.

Main Results:

• Athletes with ASD were significantly more likely to exhibit invalid neurocognitive test results (EVIs).
• A notable interaction was found between ASD diagnosis, LD, and academic performance on test validity.
• Individuals with ASD and LD reporting Below Average academic performance showed the highest rates of invalid scores.
• Main effects of diagnosis and academic performance impacted all ImPACT composite scores except Processing Speed.

Conclusions:

• Adolescent athletes with ASD demonstrate poorer neurocognitive performance and higher rates of invalid test indicators.
• Lower academic performance exacerbates the likelihood of invalid scores and worse neurocognitive outcomes in athletes with ASD.
• Individualized baseline neurocognitive testing is essential for accurate concussion assessment in athletes with ASD.