Over the past two decades, the Sport Concussion Assessment Tool (SCAT)(SCAT is a registered trademark of the Concussion in Sport Group (CISG)) has become a foundational aspect of the evaluation and management of sport-related concussion (SRC).1–4 Born from an international consensus led by the CISG and refined through a rigorous, evidence-informed process, the SCAT series has improved and standardised the evaluation of SRC across domains, including symptoms, balance, cognition and ocular-motor function.1–4 The publication of the SCAT6 (sixth International Conference on Concussion in Sport—Amsterdam, October 2022) and its supporting evidence reviews in 2023 represents the accumulation of decades of evidence dedicated to improving athlete brain health.1 5–7

Despite widespread use and utility, the SCAT6 has neither been adapted nor validated for the needs of Para sport athletes. Several SCAT6 components, such as balance and coordination testing, are fundamentally not applicable or possible for athletes who use wheelchairs (WCs) as their primary means of mobility. The Amsterdam 2022 International Consensus Statement acknowledged this limitation, calling for future adaptations of the SCAT for Para athletes.1 In addition, the Concussion in Para Sport (CIPS) group also released an editorial calling for more research in this area.8 The CIPS group released a Position Statement highlighting areas of the SCAT that should not be used or require modifications for use with a diverse Para athlete population, but did not provide further recommendations to adapt the testing protocol.9 10

The absence of modified and validated SCAT tools for Para sport athletes represents both a clinical challenge and an issue of equity: Para sport athletes may sustain head injuries and deserve the same access to evidence-based assessment as their non-Para athlete peers. This commentary advocates for a Para SCAT6 initiative to build an evidence foundation to inform concussion evaluation and management in Para athletes.