What a Baseline Concussion Test Actually Looks Like: A Minute-by-Minute Walkthrough for Parents

If you’ve been told your child needs a baseline concussion test, you probably want to know what’s actually going to happen. Most articles say “20–45 minutes” and stop there. Here’s a thorough walkthrough of a comprehensive baseline assessment so there are no surprises.

The session typically takes 30–45 minutes total and covers four domains recommended by the 6th International Consensus Statement on Concussion in Sport (Berlin/Amsterdam, 2022–2023): symptoms, cognition, balance, and vestibular-ocular function. Your child should arrive well-rested, hydrated, and not immediately after intense physical activity. The Journal of Athletic Training recommends that athletes avoid strenuous exercise for at least two hours before testing.

Symptom inventory (3–5 minutes)

The process begins with the Post-Concussion Symptom Scale (PCSS), a 22-item checklist embedded in both the SCAT6 and ImPACT. Your child will rate symptoms on a scale from 0 (none) to 6 (severe). These include headache, dizziness, difficulty concentrating, fatigue, feeling “in a fog,” and others.

This isn’t checking for a concussion — it’s establishing what your child’s “normal” symptom profile looks like. Research published in the Journal of Neurotrauma has shown that up to 40% of healthy athletes report at least one symptom at baseline.

Cognitive assessment (20–25 minutes)

Typically a computerized test like ImPACT. For children ages 10 and up, this involves a series of computer-based tasks measuring:

• Verbal memory — remembering words
• Visual memory — remembering shapes and patterns
• Visual motor speed — matching symbols quickly
• Reaction time — clicking as fast as possible in response to stimuli

The test produces four composite scores. For younger children ages 5–9, ImPACT Pediatric uses game-like activities on an iPad with a parent present and takes about 15 minutes.

Balance testing (5–10 minutes)

The most common protocol is the modified Balance Error Scoring System (mBESS), part of the SCAT6. Your child stands in three positions — feet together, on one foot, and heel-to-toe — with eyes closed and hands on hips for 20 seconds each. A trained evaluator counts balance errors (eyes opening, stepping, stumbling, lifting hands). Some programs use smartphone-based (Sway Medical) or force plate systems (BTrackS) for more objective measurement.

Vestibular-ocular motor screening (5–10 minutes)

VOMS, developed at the UPMC Sports Medicine Concussion Program, evaluates eye movements and inner ear function. Your child will be asked to:

• Follow a moving target (smooth pursuits)
• Make rapid eye movements between two points (saccades)
• Focus on an approaching object (near point of convergence)
• Perform head movements while fixating on a target (vestibulo-ocular reflex)

The evaluator notes any symptoms triggered by these movements — according to research by Mucha et al. (2014) published in The American Journal of Sports Medicine, VOMS abnormalities are among the strongest predictors of prolonged concussion recovery.

What happens after

At Headquarters, we walk every family through the process before testing begins. No surprises, no confusion. Your child’s complete baseline results are securely stored and immediately available if an injury occurs. For the deeper technical primer, see our pillar guide on what baseline concussion testing actually is and our breakdown of the digital SCAT6.

Frequently asked questions