My Kid Has ADHD — Why Their Baseline Concussion Test Needs Special Attention

If your child has ADHD, their concussion baseline test requires extra care. This is one of the most important and least discussed topics in concussion management, and the research is clear: athletes with ADHD need individualized baselines, not population comparisons.

How ADHD shows up in baseline scores

A study published in the Journal of Athletic Training (Covassin et al., 2017) found that athletes with ADHD consistently score lower on baseline neurocognitive tests — particularly in verbal memory, visual memory, and processing speed. This isn’t a sign of impairment. It reflects the cognitive profile of ADHD.

But if a clinician doesn’t know your child has ADHD and compares their post-injury scores to population normative data (which doesn’t include ADHD-specific norms), the results can be misleading in two dangerous ways.

First, your child’s healthy baseline scores might fall in a range that normative data flags as “impaired.” Without a personal baseline, a clinician might hold a fully recovered athlete out of activity because their “normal” looks abnormal compared to the general population. Second, if the normative data happens to set the bar too low for your child’s actual abilities, genuine post-injury deficits could be missed.

The medication question

Then there’s the medication question — and it’s one nobody has fully resolved. If your child takes stimulant medication for ADHD, do they take it before the baseline test or not? A study by Elbin et al. (2016) published in the American Journal of Sports Medicine found significant differences in ImPACT scores between medicated and unmedicated ADHD athletes.

The current best practice — though no formal consensus guideline exists — is to test in whatever state the athlete will be competingin. If they play their sport on medication, baseline on medication. If they don’t, baseline without. The critical thing is to document which state was tested so post-injury testing can replicate the conditions.

Higher baseline symptom scores

Research published in PMC (Iverson et al., 2017) also shows that athletes with ADHD report higher baseline symptom scores, particularly for difficulty concentrating, fatigue, and restlessness. Without knowing these are part of your child’s everyday experience, a clinician might misattribute them to a concussion.

Additionally, athletes with ADHD may be at higher overall concussion risk. A study in the Clinical Journal of Sport Medicine found that multiple self-reported concussions were more prevalent in athletes with ADHD and learning disabilities.

How we handle it at Headquarters

At Headquarters, we flag ADHD and other neurodevelopmental conditions during intake and ensure the baseline is interpreted within that context. We document medication status, administer all testing domains (not just cognitive), and create a comprehensive picture of your child’s unique brain function.

Because the whole point of a baseline is to know what “normal” looks like for your child — not for the average child. For the broader argument, read should I get my child a baseline concussion test?

Frequently asked questions