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Axon Sports Computerized Cognitive Assessment Tool (CCAT)
Availability
Please visit this website for more information about the instrument: Axon Sports  Computerized Cognitive Tool
Classification
Core: Sport-Related Concussion (SRC)
 
Core: One of the Core Neuropsychological Function cognitive measures should be collected: Automated Neuropsychological Assessment Metrics (ANAM), Axon Sports Computerized Cognitive Assessment Tool (CCAT), CNS Vital Signs, or Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). Please note that these could be replaced by a pen or paper battery under the direction of a neuropsychologist.
Core: One of Core Symptoms Checklists should be collected: Automated Neuropsychological Assessment Metrics (ANAM), Axon Sports Computerized Cognitive Assessment Tool (CCAT), CNS Vital Signs, Child Sport Concussion Assessment Tool (Child-SCAT), Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), Post Concussion Symptom Inventory (PCSI), Post Concussion Symptoms Scale (PCS-S), Sport Concussion Assessment Tool (SCAT-3) or (SCAT-5), Standardized Symptoms Questionnaire (RPQ), or Post Concussion Symptom Inventory (PCSI).
 
Supplemental: Mitochondrial Disease (Mito) and Traumatic Brain Injury (TBI)
 
Short Description of Instrument
The Axon Sports Computerized Cognitive Assessment Tool (CCAT) uses computerized card games to test cognitive ability. Four simple tasks test processing speed, attention, learning and working memory. A baseline test represents the participant’s best effort pre-injury. The post-injury report shows whether there was significant decline in test performance post-injury.
 
The test can be completed in 8 to 10 minutes via computer. Participant responds to a series of tests in a convenient location. Children should take the test under the supervision of a responsible adult.
 
Sport-Related Concussion Specific:
 
Acute: Acute timeframe: time of injury until 72 hours
Advantages: Rapid administration time (10–15 min). Effective across multiple languages. Disadvantages: Requires internet connection to administer; the test reliability, sensitivity and specificity have been questioned; and the results require interpretation by a neuropsychologist
Age Range: 10+ years
 
Subacute: Subacute timeframe: after 72 hours to 3 months
Advantages: Computerized neurocognitive assessment battery that includes four tasks that measures: 1) processing speed, 2) attention, 3) learning, 4) working memory. Uses playing card stimuli that can reduce language/reading limitations of most computerized neurocognitive tests. Brief- requires ~10 min to administer. Disadvantages: Requires a computer and software to administer. Ideally a patient needs a baseline test for best interpretation of results. Tests should be interpreted by trained professional. Limited research supporting its reliability and validity. Heavily focused on reaction time.
Age Range: Children, Adolescents, Adults – 11+ years
 
Persistent/Chronic: Persistent/Chronic timeframe: 3 months and greater post concussion
Computerized cognitive testing. Assess working memory, attention, processing speed and visual recognition memory. Has demonstrated sensitivity for distinguishing concussion, particularly regarding reaction time.
Disadvantages: Reliability has varied depending on studies. Sensitivity during post acute stages diminishes compared to acute.
Age Range: ~8+ years
Scoring
Standard scores in processing speed, attention, learning, and working memory (M=100, SD=10) pre- and post-injury.
References
CogState. (1999). CogSport [Computer software]. Parkville, Victoria, Australia: CogState, Ltd.
Collie A, Darby D, Maruff P. Computerised cognitive assessment of athletes with sports related head injury. Br J Sports Med. 2001;35(5):297–302.
 
Collie A, Maruff P, Makdissi M, McCrory P, McStephen M, Darby D. CogSport: reliability and correlation with conventional cognitive tests used in postconcussion medical evaluations. Clin J Sport Med. 2003;13(1):28–32.
 
Eckner JT, Richardson JK, Kim H, Joshi MS, Oh YK, Ashton-Miller JA. Reliability and criterion validity of a novel clinical test of simple and complex reaction time in athletes. Percept Mot Skills. 2015 Jun;120(3):841–859.
 
MacDonald J, Duerson D. Reliability of a Computerized Neurocognitive Test in Baseline Concussion Testing of High School Athletes. Clin J Sport Med. 2015;25(4):367–372.
 
Louey AG, Cromer JA, Schembri AJ, Darby DG, Maruff P, Makdissi M, Mccrory P. Detecting cognitive impairment after concussion: sensitivity of change from baseline and normative data methods using the CogSport/Axon cognitive test battery. Arch Clin Neuropsychol. 2014;29(5):432–441.
 
Nelson LD, Pfaller AY, Rein LE, McCrea MA. Rates and Predictors of Invalid Baseline Test Performance in High School and Collegiate Athletes for 3 Computerized Neurocognitive Tests: ANAM, Axon Sports, and ImPACT. Am J Sports Med. 2015;43(8):2018–2026.
 
Nelson LD, LaRoche AA, Pfaller AY, Lerner EB, Hammeke TA, Randolph C, Barr WB, Guskiewicz K, McCrea MA. Prospective, Head-to-Head Study of Three Computerized Neurocognitive Assessment Tools (CNTs): Reliability and Validity for the Assessment of Sport-Related Concussion. J Int Neuropsychol Soc. 2016;22(1):24–37.
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