59. Does the SCAT5 % Normal Question Add Performance Validity Information to Baseline Concussion Evaluations?
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ID: 324512
2026
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Abstract
Abstract Purpose Beginning in 2017, the Sport Concussion Assessment Tool (SCAT5), and later the SCAT6, introduced without elaboration the questions: (1) “If 100% is perfectly normal, what percent of normal do you feel?” and (2) “If not 100%, why?” We assessed whether these items provided useful information regarding respondent effort and performance in baseline concussion evaluations. Method The SCAT5 was administered during preparticipation medical testing to 1,069 university athletes, aged 17-25 (M=19.69, SD=1.50; 64% male). Reasons for feeling less than 100% normal included: sleep/tired (46%), physical (21%), emotional (11%), cognitive (1%), travel-related (4%), multiple (6%), and other (11%). Results 46.1% of participants reported feeling 100% normal. Only 25% (n=269) of the participants reported feeling both 100% normal and endorsed zero symptoms on the SCAT5 symptom evaluation. Higher % normal scores were associated with lower SCAT5 symptom totals and symptom severity scores (r = -.413 & -.414, respectively, p <.001). However, when compared across five categories of % normal, no difference was found for the various SCAT5 cognitive and balance domains (Λ = .972, F(24, 3678) = 1.26, p = .177, ηp2 = .007). Conclusions The current results show less than ideal reliability of reports of feeling normal given the disconnect with the symptom evaluation responses. Moreover, the finding of no difference between feelings of normalcy and performance on the cognitive and balance domains of the SCAT5 suggests that the % normal item is irrelevant in interpreting SCAT5 performance.
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openalex_W7202076699
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| Authors | C Baird, K Murphy, S Baath, A Rizzo, F Webbe |
| Journal | archives of clinical neuropsychology : the official journal of the national academy of neuropsychologists |
| Year | 2026 |
| DOI |
10.1093/arclin/acag055.059
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| Keywords | Keywords not found |
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