Factor analysis of the adolescent version of the behavioural assessment screening tool (BAST-A) in adolescents with concussion

Objective: Develop and validate the Behavioral Assessment Screening Tool for Adolescents with brain injury. Setting: Concussion clinics Participants: Adolescents with mild traumatic brain injury 3 months after initial concussion clinic visit (n = 138). Design: Assessment development and validation (cross-sectional cohort) study Main Measures: Behavioral Assessment Screening Tool–Adolescent Results: Expert panel members added or modified items specific to adolescents to the original Behavioral Assessment Screening Tool for adults. The Content Validity Index was 97.2%. Exploratory factor analysis of the Behavioral Assessment Screening Tool–Adolescent reduced the initial 70 items to 46 primary items with a 3-factor solution: Negative Affect & Fatigue, Executive & Social Function, and Risk Behaviors. Internal consistency reliabilities ranged from good to excellent for all factors (Cronbach’s α =.80-.95). We retained four secondary maladaptive coping items (from an initial six), though these require further modification and testing (Cronbach’s α =.67). Conclusion: The Behavioral Assessment Screening Tool for Adolescents, a measure of neurobehavioral symptoms after mild traumatic brain injury in adolescents, has a multidimensional factor structure with evidence of good internal consistency reliabilities. Future work will further evaluate its convergent and discriminant validity and employ item response theory analyses for validation in a new sample of adolescents with concussion.