LAUSR

Prior research has not evaluated symptom-reporting differences between international and domestic athletes for baseline concussion symptoms. Since universities enroll both, it is important to consider differences for interpretation of post-trauma assessments. This study compared symptom endorsements between international and domestic athletes utilizing the Sport Concussion Assessment Tool-5th Edition (SCAT5) and Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). 622 domestic collegiate athletes, aged 17-25 years (M = 19.29, SD = 1.44; 65% male), and 167 international collegiate athletes, aged 17-24 (M = 20.27, SD = 1.61; 62% male) were administered the SCAT5 and ImPACT. All symptoms were compared. International participants (M = 3.46; SD = 3.99) reported significantly more symptoms, U = 42561, p < 0.001 (Mann-Whitney U Test), on the SCAT5 compared to domestic participants (M = 2.43; SD = 3.20), and at a greater severity, U = 43404, p = 0.001, among international participants (M = 5.04; SD = 7.27) compared to domestic participants (M = 3.70; SD = 5.54). Of the 22 SCAT5 symptoms, 9 were endorsed more frequently by international students. International participants (M = 4.95; SD = 7.57) also reported significantly more symptoms, U = 43514, p = 0.001, on the ImPACT compared to domestic participants (M = 3.18; SD = 5.35). Of the 22 ImPACT symptoms, 12 were endorsed more frequently by international students and 2 by domestic. International athletes report significantly more symptoms and at a greater severity on ImPACT and SCAT5 compared to domestic athletes. Differences did not appear related to travel and fatigue such as sensitivity to light and noise, difficulty concentrating, and feeling more emotional. Over 20,000 international student-athletes are enrolled in the NCAA, it is important to note differences observed in symptom reporting for appropriate baseline evaluation (NCAA, 2019).