Impact of non-credible cognitive performance on multidisciplinary treatment outcomes in youth with persisting symptoms after concussion.

Authors

Kelsey Diane May, Sean Rose, Cody Solesbee, Emily Divirgilio, Kathleen Shiplett, Ashley Davidson, Kelly McNally

Published in

Applied neuropsychology. Child. Pages 1-9. Oct 07, 2026. Epub Oct 07, 2026.

Abstract

This study characterizes patterns of non-credible cognitive performance, clinical presentations and functional outcomes, and multidisciplinary treatment response in youth with persisting symptoms after concussion. A retrospective analysis of demographic data, injury factors, symptom ratings, and functional outcomes was conducted in 136 patients (8-20 years-old; 64% female) presenting for multidisciplinary concussion care. Concussion mechanisms included sports, motor vehicle accidents, recreational activities, falls, assaults, and other mechanisms. Findings revealed approximately one-fourth of youth demonstrated non-credible cognitive performance. Compared to youth with credible cognitive performance, youth with non-credible cognitive performance were more likely to have premorbid attention or learning problems, non-credible neurologic exam findings, and significantly poorer cognitive performance across all tests apart from word reading. While youth with non-credible cognitive performance endorsed significantly more symptoms than those with credible cognitive performance at initial presentation and throughout the course of multidisciplinary treatment, their symptoms improved at a similar rate compared to those with credible cognitive performance. Additionally, groups did not differ significantly in school absences or parent-reported quality of life, despite higher self-reported symptom burden in the non-credible group. These findings suggest that youth with persisting symptoms who demonstrate non-credible cognitive performance similarly benefit from standard multidisciplinary concussion care, though they may continue to report higher symptoms throughout treatment. Additionally, youth with non-credible cognitive performance may also display non-credible findings on other aspects of multidisciplinary evaluations, highlighting the need for further research into individualized care models.

PMID:
42844999
Bibliographic data and abstract were imported from PubMed on 08 Oct 2026.

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