Research papers that support the present guideline recommendations:

Araujo, G. C., Antonini, T. N., Monahan, K., Gelfius, C., Klamar, K., Potts, M., … Bodin, D. (2014). The relationship between suboptimal effort and post-concussion symptoms in children and adolescents with mild traumatic brain injury. Clinical Neuropsychologist, 28(5), 786–801.

Babcock, L., Kurowski, B. G., Zhang, N., Dexheimer, J. W., Dyas, J., & Wade, S. L. (2017). Adolescents with Mild Traumatic Brain Injury Get SMART: An Analysis of a Novel Web-Based Intervention. Telemedicine and E-Health, 23(7), 600–607.

Babikian, T., McArthur, D., & Asarnow, R. F. (2013). Predictors of 1-month and 1-year neurocognitive functioning from the UCLA longitudinal mild, uncomplicated, pediatric traumatic brain injury study. Journal of the International Neuropsychological Society, 19(2), 145–154.

Bonfield, C. M., Lam, S., Lin, Y., & Greene, S. (2013). The impact of attention deficit hyperactivity disorder on recovery from mild traumatic brain injury. Journal of Neurosurgery: Pediatrics, 12(2), 97–102.

Brooks, B. L., Mannix, R., Maxwell, B., Zafonte, R., Berkner, P. D., & Iverson, G. L. (2016). Multiple Past Concussions in High School Football Players. American Journal of Sports Medicine, 44(12), 3243–3251.

Brooks, B. L., McKay, C. D., Mrazik, M., Barlow, K. M., Meeuwisse, W. H., & Emery, C. A. (2013). Subjective, but not Objective, Lingering Effects of Multiple Past Concussions in Adolescents. Journal of Neurotrauma, 30(17), 1469–1475.

Brooks, T. M., Smith, M. M., Silvis, R. M., Lerer, T., Mulvey, C. H., Maitland, R., … Smith, S. R. (2017). Symptom-Guided Emergency Department Discharge Instructions for Children with Concussion. Pediatric Emergency Care, 33(8), 553–563.

Collings, L. J., Cook, N. E., Porter, S., Kusch, C., Sun, J., Virji-Babul, N., … Panenka, W. J. (2017). Attention-deficit/hyperactivity disorder is associated with baseline child sport concussion assessment tool third edition scores in child hockey players. Brain Injury, 31(11), 1479–1485.

Cook, N. E., Huang, D. S., Silverberg, N. D., Brooks, B. L., Maxwell, B., Zafonte, R., … Iverson, G. L. (2017). Baseline cognitive test performance and concussion-like symptoms among adolescent athletes with ADHD: examining differences based on medication use. Clinical Neuropsychologist, 31(8), 1341–1352.

Cordingley, D., Girardin, R., Reimer, K., Ritchie, L., Leiter, J., Russell, K., & Ellis, M. J. (2016). Graded aerobic treadmill testing in pediatric sports-related concussion: safety, clinical use, and patient outcomes. Journal of Neurosurgery: Pediatrics, 18(6), 693–702.

DeMatteo, C. A., Randall, S., Lin, C. Y. A., & Claridge, E. A. (2019). What comes first: Return to school or return to activity for youth after concussion? Maybe we don’t have to choose. Frontiers in Neurology, 10(JUL), 1–9.

Donders, J., & DeWit, C. (2017). Parental ratings of daily behavior and child cognitive test performance after pediatric mild traumatic brain injury. Child Neuropsychology, 23(5), 554–570.

Elbin, R. J., Kontos, A. P., Kegel, N., Johnson, E., Burkhart, S., & Schatz, P. (2013). Individual and combined effects of LD and ADHD on computerized neurocognitive concussion test performance: Evidence for separate norms. Archives of Clinical Neuropsychology, 28(5), 476–484.

Gardner, R. M., Yengo-Kahn, A., Bonfield, C. M., & Solomon, G. S. (2017). Comparison of baseline and post-concussion ImPACT test scores in young athletes with stimulant-treated and untreated ADHD. Physician and Sportsmedicine, 45(1), 1–10.

Haarbauer-Krupa, J. K., Comstock, R. D., Lionbarger, M., Hirsch, S., Kavee, A., & Lowe, B. (2018). Healthcare professional involvement and RTP compliance in high school athletes with concussion. Brain Injury, 32(11), 1337–1344.

Haider, M. N., Leddy, J. J., Pavlesen, S., Kluczynski, M., Baker, J. G., Miecznikowski, J. C., & Willer, B. S. (2018). A systematic review of criteria used to define recovery from sport-related concussion in youth athletes. British Journal of Sports Medicine, 52(18), 1179–1190.

Iverson, G. L., Atkins, J. E., Zafonte, R., & Berkner, P. D. (2016). Concussion History in Adolescent Athletes with Attention-Deficit Hyperactivity Disorder. Journal of Neurotrauma, 33(23), 2077–2080.

MacDonald, J., Patel, N., Young, J., & Stuart, E. (2018). Returning Adolescents to Driving after Sports-Related Concussions: What Influences Physician Decision-Making. Journal of Pediatrics, 194, 177–181.

Mannix, R., Iverson, G. L., Maxwell, B., Atkins, J. E., Zafonte, R., & Berkner, P. D. (2014). Multiple prior concussions are associated with symptoms in high school athletes. Annals of Clinical and Translational Neurology, 1(6), 433–438.

Marshall CM, Chan N, Tran P, et al. The use of an intensive physical exertion test as a final return to play measure in concussed athletes: a prospective cohort. Phys Sportsmed [Internet]. 2019 Apr 3;47(2):158–66. Available from:

McCrory, P., Meeuwisse, W., Dvořák, J., Aubry, M., Bailes, J., … Vos, P.E. (2017) Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. British Journal of Sports Medicine. 51(11),838-847.

McKay, C. D., Schneider, K. J., Brooks, B. L., Mrazik, M., & Emery, C. A. (2014). Baseline Evaluation in Youth Ice Hockey Players: Comparing Methods for Documenting Prior Concussions and Attention or Learning Disorders. Journal of Orthopaedic & Sports Physical Therapy, 44(5), 329–335.

Nowacki, R., van Eldik, N., Eikens, M., Roijen, R., Haga, N., Schott, D., … Wennekes, M. (2017). Evaluation of a follow-up program for mild traumatic brain injury in schoolchildren. European Journal of Paediatric Neurology, 21(2), 382–387.

Reed, N., Taha, T., Monette, G., & Keightley, M. (2016). A Preliminary Exploration of Concussion and Strength Performance in Youth Ice Hockey Players. International Journal of Sports Medicine, 37(9), 708–713.

Root, J. M., Zuckerbraun, N. S., Wang, L., Winger, D. G., Brent, D., Kontos, A., & Hickey, R. W. (2016). History of Somatization Is Associated with Prolonged Recovery from Concussion. Journal of Pediatrics, 174, 39–44.e1.

Sady, M. D., Vaughan, C. G., & Gioia, G. A. (2014). Psychometric characteristics of the postconcussion symptom inventory in children and adolescents. Archives of Clinical Neuropsychology, 29(4), 348–363.

Salinas, C. M., Dean, P., LoGalbo, A., Dougherty, M., Field, M., & Webbe, F. M. (2016). Attention-Deficit Hyperactivity Disorder Status and Baseline Neurocognitive Performance in High School Athletes. Applied Neuropsychology: Child, 5(4), 264–272.

Tamura K, Furutani T, Oshiro R, et al. Concussion recovery timeline of high school athletes using a stepwise return-to-play protocol: Age and sex effects. J Athl Train [Internet]. 2020 Jan 1;55(1):6–10. Available from:

Date Updated: January 4, 2021