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The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is the most widely used computer-based concussion assessment in sports (Kerr et al., 2015; Lovell, 2018). ImPACT scores are used to establish baseline levels of cognitive function and symptom severity, track changes in cognition and symptoms following concussion, and monitor recovery trajectory to assist in making return to play decisions following injury (Lovell et al., 2004; Mayers & Redick, 2012). Although ImPACT was initially developed to be administered in English, it has been translated into 21 different languages (Lovell, 2006; Lovell, 2018). Research is needed to establish whether the currently available translations are psychometrically comparable to the original English language version, in order to ensure linguistically, culturally, and clinically competent concussion assessment (AERA, 2014; Ardila, 1995; Fletcher-Janzen et al., 2000; Judd et al., 2009; Tsushima et al., 2020).
The available literature examining Spanish-speaking individuals is limited by a number of factors but suggests differences in baseline cognitive performance and symptom reporting. As for cognitive performance, Lehman Blake et al. (2015) found that bilingual Spanish- and English-speaking university students performed better on Verbal Memory and Visual Motor Speed composites when taking ImPACT in English rather than Spanish. Ott et al. (2014) reported that bilingual adolescent athletes who tested in Spanish performed poorer on all composite scores when taking ImPACT in Spanish compared to bilinguals who tested in English and monolingual English speakers. They also found that bilinguals who tested in English scored poorer on Verbal Memory, Visual Motor Speed, and Reaction Time composite scores compared to monolingual English speakers. The largest between-group differences were for Visual Motor Speed and Reaction Time, respectively. Jones et al. (2014) also reported differences in Visual Motor Speed and Reaction Time composites between professional baseball players with high school education who were native Spanish and English speakers from the USA, Canada, Cuba, Dominican Republic, Mexico, Puerto Rico, Nicaragua, and Venezuela. Karr et al. (2021) also found that adolescent athletes tested in Spanish had lower scores than those tested in English on the Visual Motor Speed and Reaction Time composites, with a larger group difference for boys compared to girls. Thus, previous work suggests that ImPACT composite baseline scores for monolingual English speakers are better than those for bilingual Spanish/English speakers tested in English...