Alpha testing of items and development of the test modules from early versions ImPACT

Early item development was conducted from 1994-1996 based on the need to assess the relevant neurocognitive domains that are often affected by concussion. The assessment was based on the author’s prior experience in administering and interpreting traditional “paper and pencil” tests in professional and amateur athletes. Items were initially selected based on measuring the key domains of memory and processing speed. Within these broad domains, specific subtests were created that measured word memory; X’s and O’s (spatial memory); symbol match (memory for symbols and reaction time); three letter memory (verbal memory and motor speed) and color match (reaction time). See Chapter 2 for a complete description of the subtests. After this data was consolidated and evaluated, several items were eliminated from further consideration, some items were modified based on field tester recommendations, and others were retained in their original form. For example, the alpha version of ImPACT included a sequential memory task that was dropped because it did not provide unique information.

Alpha testing was completed in one Midwestern University and four high schools in the Midwest. From 1996-2000, this initial version of the test was utilized as a research tool in ten universities and eight high schools in the Midwest and in select high schools in Maine and Oregon. Subsequent research did not reveal any geographic difference between groups (Lovell et al., 2003). Items were reviewed again using the aforementioned criteria and once selected, the remaining items were piloted in the Detroit metropolitan area. A final review of the items was conducted with data on the ease of administration, the individual’s ability to understand and complete the task, the performance differences between individuals who were concussed versus those who were not (sensitivity and specificity). This final version was published as the Desktop version of ImPACT.

The Desktop version was in use for approximately 5 years until an online version of the test was developed and validated. The items from the online version of the test formed the basis of ImPACT Version 4 as no new items were added or deleted.