A NPA works without baseline testing because baseline testing is more valuable as a basis for interpreting sports related neuro cognitive testing (ImPACT, CNS Vital Signs, CogSport, BrainMinder, etc) used after sports concussions when return to play decisions are being made.

The NPA tests are scored against a database of the general population normalized for age and education. Plus, there are some tests that measure intelligence that can be compared to current function. The premise is that intelligence has less deterioration from brain injuries than cognitive function.

For example, I score in the top 88th to 99th percentile of the population on the intelligence scales but at the bottom 10% for processing speed, 5% for auditory memory, 12% for visual memory. There is no way my low memory or processing speed could have allowed my intelligence to develop to the point it did. This means my cognitive functional decline was after my intelligence developed and that my cognitive dysfunctions are organic.

Once your son gets his report, he will be able to try to accept the reality of his dysfunctions so he can try to learn work-arounds rather than constantly being frustrated as he fights against them. The self-doubt is very stressful. Moving on is ieasier with understanding.

btw, With all the symptoms you son has, I think it is valuable to try to separate the physical ones from the cognitive/neurological symptoms so they can be treated separately. There are no treatments for a broad range of concussion symptoms. For example, it sounds like he needs some specialist care for his vertebra, thoracic and cervical. Very few neuros have the skills for this. A Physiatrist (Physical Medicine and Rehabilitation) are often better.

My best to you both.