Understanding the Basics of Concussion Testing

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Concussion testing is becoming more common among young high school and college athletes. A recent understanding of the significance of concussions has led to efforts to prevent concussions and to identify them when they happen. A better-organized approach to the early recognition and management of concussion is aimed at reducing the long-term consequences for young players.

Student-athletes are often required to undergo pre-concussion testing, particularly when participating in high impact contact sports or highly competitive travel leagues.

Parents and student-athletes who are given forms and instructions for pre-concussion testing often have questions about what these tests mean.

Pre-Concussion Testing

Pre-concussion testing generally includes a set of neuropsychological tests developed to assess and score a young athlete on skills that involve several aspects of the athlete’s brain function. Pre-concussion tests include tasks that evaluate problem-solving, response time, speed, vision, and coordination.

There is not a single gold standard pre-concussion screening tool that is required by an authoritative medical or sports association. There are a variety of ways to establish a pre-concussion score, including an in-person clinical evaluation or a pre-set questionnaire. There are a number of available skills tests on the market that can be used to establish a baseline score for a player before the season begins, and your child’s school or sports league can search through the different options and adopt one or more of the available programs.

Pre-concussion tests may be scored by a computer or by a medical professional, depending on the type of examination and on the rules of the league or the school. The baseline results are to be recorded and saved so that if an athlete suffers from a suspected concussion, he or she can take a repeat test for comparison.

Concussion Testing

Concussion testing is an assessment designed to determine whether a person has experienced a concussion.

A concussion is a temporary problem with neurological function caused by a head injury. A severe head injury that causes bruising or bleeding in the brain is expected to show evidence of injury on a brain CT or brain MRI. Mild head trauma, however, can cause tiny changes in the brain that do not show in brain imaging studies. While severe head trauma can certainly cause a concussion, concussions resulting from mild head injuries that are not severe enough to cause identifiable bleeding or bruising in the brain are far more common in sports.

It is believed that the neurological symptoms of a concussion are the result of these microscopic changes in the brain that cannot be identified by tests such as a brain MRI or brain CT scan. Since it is not possible to diagnose tiny injuries in the brain with diagnostic imaging tests, careful examination of symptoms and neuropsychological function is often the only way to identify a concussion.

The symptoms of a concussion can vary, including pain, confusion, mood changes, coordination problems, trouble thinking, and sleep disturbances.

Concussion symptoms can also be fairly subtle. After a concussion, you or your child might complain about things like "feeling off" or "not getting things." Since some of the effects of a concussion can be so vague, pre-concussion testing is a convenient baseline to use as a comparison when there is a suspected concussion.

The main reason that an athlete needs pre-concussion testing is that healthy and intelligent individuals do not perform exactly the same on tests that measure skills such as speed, accuracy, and eye movements. This means that performance on a post-concussion test is not necessarily "good" or "bad" on its own, but is based on whether or not there is a significant decline in comparison to the baseline that was set prior to the head injury.

If a student-athlete has a slower response or lower accuracy on a post-concussion test after a head injury, then the lower score could be a sign of a concussion. Along with a neurological examination and overall symptoms such as sleepiness, pain, or trouble concentrating, the results of a post-concussion test can be used to help determine whether the athlete has suffered from a concussion.

What You Should Expect If You Have Had a Concussion

If you or your child has suffered from a concussion, then you should expect to be under the care of a physician until your symptoms resolve. Typically, most people recover from a mild concussion within months, because the brain injury of a concussion is generally mild and heals well. Recovery often includes getting more rest than usual and avoidance of activities that could cause head injuries.

For the most part, experiencing one concussion rarely results in long-term consequences. Repeated concussions, however, can cause serious and lasting effects, especially if a repeat concussion occurs before full recovery from a concussion. Long-term effects of repeated concussions or unusually severe concussions include permanent cognitive (thinking) problems and mood problems.

This makes resting and avoiding risky activities so important while healing from a concussion.

A Word From Verywell

A concussion is a type of injury that has been getting a great deal of attention in recent years. The medical understanding of concussions has increased dramatically. Researchers have found evidence of microscopic injuries in the brains of deceased individuals who had suffered from symptoms of concussion, which validates that there are indeed real physical changes in the brain that result from head injuries, even if they are too small to ‘see’ on the currently available brain imaging technology. Yet, so far, there is no other concrete verifiable evidence that can prove that a concussion has happened while someone is still alive. This is why pre- and post-concussion testing is so important.

If you or a loved one has had a concussion, it is important for you to know that you have a very strong chance of recovery within a few months. Rest is the best approach to healing after a concussion. Studies show that there is no benefit to forcing yourself to do more than you feel ready for, and there is a chance that exhaustion and excessive stress can hinder recovery after a concussion.


Hall E, Cottle J, Ketcham C, Patel K, Barnes KP, Concussion Baseline Testing: Preexisting Factors, Symptoms, and Neurocognitive Performance,, J Athl Train. 2017 Jan 10.