ImPACT vs. SCAT6 vs. King-Devick vs. VOMS: Every Baseline Concussion Test Compared

If you’ve researched baseline concussion testing, you’ve probably encountered a confusing alphabet soup of test names. Here’s a clear, independent comparison of every major tool — what each measures, how long it takes, what it costs, and what it misses.

ImPACT

Immediate Post-Concussion Assessment and Cognitive Testing is the most widely used computerized neurocognitive test globally. Developed at the University of Pittsburgh and FDA-cleared, it measures verbal memory, visual memory, visual motor speed, and reaction time in about 20–25 minutes. It produces a detailed report with validity indicators and has the most extensive research base of any concussion assessment tool, with over 1,000 published studies.

Cost: $15–$20 at home (ImPACT Baseline), $25–$75 in-clinic. Limitation: it only tests cognition. It misses balance, vestibular, and oculomotor deficits entirely.

SCAT6

Sport Concussion Assessment Tool, 6th edition, is the internationally recognized gold standard for comprehensive concussion assessment, endorsed by the Concussion in Sport Group and published in the British Journal of Sports Medicine (2023). It includes a symptom checklist, cognitive screening (orientation, immediate memory with a 10-word list, concentration tasks including timed Months in Reverse), neurological examination, balance testing (mBESS), and a dual-task tandem gait test new to SCAT6.

It’s free, paper-based, and designed to be administered by healthcare professionals. The Child SCAT6 is available for athletes under 13. Limitation:it’s clinician-dependent, requires training, and doesn’t produce the kind of computerized composite scores that allow for precise statistical comparison over time.

King-Devick Test

Measures rapid number naming speed, capturing saccadic eye movements, attention, and language processing in under two minutes. It requires only three laminated cards (or a tablet app) and a stopwatch. It’s been validated across boxing, MMA, rugby, hockey, and football in studies published in journals including the British Journal of Sports Medicine and Neurology. It can be administered by non-medical personnel, making it the most practical sideline tool available.

Limitation:it’s primarily an oculomotor screening tool and doesn’t assess memory, balance, or symptoms.

VOMS

Vestibular/Ocular Motor Screening evaluates smooth pursuit, saccades, convergence, vestibulo-ocular reflex, and visual motion sensitivity. Developed at UPMC and published by Mucha et al. (2014) in The American Journal of Sports Medicine, it’s highly sensitive to concussion — with near point of convergence distance ≥5cm increasing identification probability by 38%. Research shows VOMS abnormalities are the best predictor of prolonged recovery.

Limitation: it requires trained administration and interpretation, and provokes symptoms in some patients.

Other tools worth knowing

• BESS / mBESS — clinical balance assessment (free, part of SCAT6)
• BTrackS — instrumented force plate balance ($1,500–$3,000 for the device)
• C3 Logix — iPad-based multi-domain assessment (Cleveland Clinic)
• Sway Medical — smartphone-based balance testing (FDA-cleared)
• DANA — for military applications (DOD-developed)

Our take

At Headquarters, we don’t rely on any single tool. Our baseline protocol combines cognitive testing, balance assessment, vestibular-ocular screening, and symptom inventory — because, as the research consistently shows, no single test captures the full picture. For a head-to-head of the commercial products, see our HQ Baseline vs. ImPACT vs. Sway comparison.

Frequently asked questions