The effect of effort on baseline neuropsychological test scores in high school football athletes

Objective: Poor effort on baseline neuropsychological tests is expected to influence interpretation of post-concussion assessment scores. Our study examined effort in an athletic population to determine if poor effort effects neuropsychological test performance. Methods: High school athletes (N = 199) were administered a brief neuropsychological test battery, which included the Dot Counting Test (DCT) and the Rey 15-Item Test with recognition trial. One-way analyses of variance were used to compare groups with adequate and poor effort test performance. Results: Most athletes (N = 177; 89%) exerted adequate effort while a number of athletes (N = 22; 11%) exerted poor effort on the DCT. Statistically significant differences existed between effort groups (p < 0.05) on several of the neuropsychological tests. Conclusions: Poor effort was observed in the athletic population during baseline testing and athletes with poor effort displayed statistically significant differences in performance on neuropsychological tests. Adding an effort test to baseline examinations may improve post-concussion test score interpretations.