Concussion Baselines: A Fall Guide for Parents

Before every season, parents run through the same checklist: physicals, equipment, practice schedules. One question rarely makes the list. If your child sustained a concussion, would you know whom to call? And would that clinician know anything about your child before the injury?

A concussion baseline is one way to answer the second question. It records certain thinking skills while your child is healthy, so that if a concussion happens later, there is a personal reference point to compare against. With winter sports about to start, it is worth understanding what a baseline can do, what it cannot, and whether it makes sense for your family.

What a baseline measures

A baseline assessment looks at memory, attention, processing speed and reaction time. A symptom questionnaire also records anything already present during a normal week, such as headaches, poor sleep or trouble concentrating.

After an injury, the clinician compares new results with that earlier snapshot. The baseline does not stand alone. It adds information to an evaluation that also weighs symptoms, medical history and examination findings.

Why your child’s own normal matters

Every child arrives with different strengths, learning needs and everyday symptoms, and those differences matter when interpreting a test. Research has found that athletes with ADHD or learning disabilities can score differently on computerized baseline tests, and report more symptoms before any injury, than athletes without those diagnoses.¹

Age-based norms still matter. A valid personal baseline adds a second reference point, one built around your child rather than an average.

If your child has ADHD, a learning difference, previous concussions, migraines or mental health concerns, share that history with whoever evaluates them. A baseline records how your child performs. It does not assess those conditions.

Does every child need one?

No. Pediatric consensus recommendations do not call for routine, mandatory baseline testing for every child.² Children’s thinking skills develop quickly, which makes results harder to interpret over time, and good concussion care is entirely possible without a baseline.

Whether one makes sense depends on your child’s age, the test being used, and who will interpret the results. And if your child is injured and has no baseline, do not wait. Get them evaluated.

When to test, and testing from home

The best time for a baseline is before an injury, when your child is healthy and able to follow instructions. Preseason is convenient, but mid-season is not too late if your child is well. A child with a suspected concussion needs an injury evaluation, not a new baseline.

There is no single retesting schedule that fits every child. It depends on age and on the test being used, so ask the provider when an update makes sense.

Testing does not have to happen in a clinic.

At Patel Concussion Institute, I administer and interpret baseline testing through secure telehealth. Families need a computer with a keyboard, mouse and camera, plus a quiet room, and we confirm telehealth location eligibility when scheduling.

Wherever your child is tested, a few questions are worth asking. Who gives the test, and who interprets it? Is it appropriate for my child’s age? How are results checked for validity? Can the clinician who treats my child after an injury actually access them? If your child’s school offers baseline testing, the same questions apply.

What a baseline cannot do

A test score alone cannot clear a child to return to sport. A child can match their previous score and still have symptoms or other findings that need care. Return-to-sport decisions also depend on a clinical assessment, how your child is managing at school, and progress through a supervised return-to-sport plan.

A baseline supports that decision. It does not make it.

If you suspect a concussion

Remove your child from play right away and have them assessed by a healthcare professional. They should not return to play that day, even if they start to feel better.

Some signs call for emergency care, not a specialty appointment: a headache that keeps getting worse, repeated vomiting, a seizure, weakness, increasing confusion, or difficulty waking up. Do not wait.

How our Concierge Baseline Program works

For families who want a baseline, our PCI Concierge Baseline Program pairs testing with a clear place to turn if an injury happens. It is $50 per year for individuals 12 and older and includes testing with Patel Concussion Institute through secure telehealth, an annual baseline update, secure storage of results, and priority scheduling after a concussion.

Membership renews each year. Concussion evaluation and treatment visits are billed separately, and priority scheduling never replaces emergency care.

A baseline will not prevent a concussion. What it can do is make the evaluation that follows more personal and give your family a clear first call if something happens.

You can read the full details on the Concierge Baseline Program page.

The Patel Concussion Institute provides comprehensive, multi-domain concussion evaluation and individualized treatment via telehealth in most states, for patients whose recovery has not followed the expected course.

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This article is intended for general education and does not substitute for individualized medical advice. Anyone with concerning symptoms after a head injury should be evaluated by a qualified healthcare professional.

References

1. Elbin RJ, Kontos AP, Kegel N, Johnson E, Burkhart S, Schatz P. Individual and combined effects of LD and ADHD on computerized neurocognitive concussion test performance: evidence for separate norms. Arch Clin Neuropsychol. 2013;28(5):476-484. doi:10.1093/arclin/act024

2. Davis GA, Schneider KJ, Anderson V, et al. Pediatric sport-related concussion: recommendations from the Amsterdam consensus statement 2023. Pediatrics. 2024;153(1):e2023063489. doi:10.1542/peds.2023-063489

About the author:

Shan Patel, PsyD, is a neuropsychologist and concussion specialist who completed his fellowship through the UPMC Sports Medicine Concussion Program. He is the Owner and CEO of the Patel Concussion Institute (PCI), a telehealth-based practice serving patients nationally via PSYPACT, and serves as Clinical Director of the University Orthopedic Care, Concussion Program, and Integrative Behavioral Health Program, overseeing operations across 14 hospital-based clinics in Florida.