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How Often Should You Renew Your Baseline? The Age-Based Schedule Nobody Agrees On
The evidence behind specific renewal intervals is thinner than most people realize.
The recommended baseline renewal schedule varies by age, developmental stage, and source — and the truth is that the evidence supporting specific intervals is thinner than most people realize.
The general framework
Most clinical guidelines converge on a general framework: annual renewal for children under 13 (due to rapid neurocognitive development), biennial (every two years) for adolescents 13 and older, and every 2–3 years for adults. UPMC Sports Medicine recommends annual baselines for athletes 12 and under, and biennial for those 13 and up. Inova Sports Medicine and OSS Therapy follow similar age-based schedules.
What the psychometric data shows
But the psychometric evidence behind these intervals raises questions. Research on ImPACT’s test-retest reliability by Elbin et al. (2011), published in the Journal of Athletic Training, reported one-year ICCs of 0.62–0.85 across the four composite scores. Schatz (2010), investigating two-year reliability published in Applied Neuropsychology, found degradation to ICCs of 0.46–0.74. At two years, verbal memory reliability dropped to 0.46 — which is considered poor by psychometric standards. This means a baseline from two years ago may not accurately represent the athlete’s current cognitive function.
Why young athletes need annual renewal
For young athletes, the case for annual renewal is strongest. A child’s brain undergoes dramatic neurocognitive development between ages 5 and 13, with measurable year-over-year improvements in processing speed, working memory, and reaction time. A baseline taken at age 8 doesn’t represent the same brain at age 10.
After injury: re-baseline
For adults with stable cognitive function, biennial or triennial renewal is generally appropriate — unless an intervening concussion or significant health change warrants a fresh baseline. See our piece on establishing a new baseline after concussion.
At Headquarters, we recommend following age-based renewal schedules, with annual renewal for younger athletes and biennial renewal for teens and adults. We also recommend re-baselining after any concussion, once the athlete is fully cleared, to establish an updated reference point.