Should I Get My Child a Baseline Concussion Test? Here's What the Science Actually Says

It’s the question we hear more than any other from parents: “Is a baseline concussion test really worth it?” The honest answer is more nuanced than most clinics will tell you.

A 2024 study from the NCAA-DoD Concussion Assessment, Research, and Education (CARE) Consortium — published in the American Journal of Sports Medicine — analyzed data from thousands of collegiate athletes and found that 86.7% showed no additional diagnostic benefit from having an individual baseline compared to using population-level normative data. That’s a striking number, and it’s worth sitting with.

So does that mean baseline testing is useless? Not at all. What it means is that for the average healthy athlete with no complicating factors, normative data (population averages for their age and sex) does a reasonably good job as a comparison point. But “average” is doing a lot of heavy lifting in that sentence.

Why your child probably isn’t “average”

Here’s where baselines become irreplaceable: your child isn’t average. If they have ADHD, a learning disability, a history of prior concussions, anxiety, migraines, or autism spectrum disorder, normative data doesn’t capture their “normal.” Their healthy brain function may look very different from the population average — and without a personal baseline, a clinician comparing their post-injury scores to normative data might either miss a real deficit or falsely flag a healthy score as impaired.

Research published in the Journal of Athletic Training (Covassin et al., 2017) has demonstrated that preexisting factors including ADHD and sex significantly influence baseline neurocognitive performance. For these athletes, an individual baseline isn’t a nice-to-have — it’s the only way to know what “back to normal” actually looks like.

The benefit the research doesn’t capture

There’s another benefit the research doesn’t capture well in its statistics: education. When families go through the baseline testing process, they learn what concussion symptoms look like, what to do if one is suspected, and why early reporting matters. A 2024 qualitative study in the Journal of Science and Medicine in Sport (Salmon et al.) found that the greatest value of baseline testing in community rugby may actually be cultural — normalizing concussion disclosure and building awareness across organizations.

Put differently: even when the numerical baseline doesn’t move a clinical decision, the act of sitting through one changes how a family thinks about head injury. And that change matters on the day of the hit.

What “done well” actually means

At Headquarters, we believe baseline testing is most valuable when it’s done well. A properly administered, multi-domain baseline (cognition, balance, vestibular-ocular screening, and symptoms) gives clinicians a personalized reference point that population data simply cannot replicate. A poorly administered one — taken in a noisy gym with 30 other distracted kids — may be worse than no baseline at all. (We wrote a whole piece on why that’s true and what to ask providers.)

Our recommendation

Yes, get the baseline.But make sure it’s done right, in a quiet environment, with your child rested and focused. And understand that the baseline is one tool in a larger clinical picture — not a crystal ball.

If you want the longer technical explanation of what’s actually in a baseline, read our pillar guide on what baseline concussion testing actually is.

Frequently asked questions