HQ BaselineSCAT updates
SCAT5 vs. SCAT6: What Changed, What Didn't, and Why It Matters for Your Baseline
If your athlete's baseline was done using SCAT5, here's what you need to know.
The Sport Concussion Assessment Tool is the international gold standard for concussion evaluation, published by the Concussion in Sport Group in the British Journal of Sports Medicine. It was updated from SCAT5 (2017) to SCAT6 (2023) following the 6th International Conference on Concussion in Sport in Amsterdam. If your athlete’s baseline was done using SCAT5, here’s what you need to know.
What changed in SCAT6
The immediate memory test now uses a mandatory 10-word list instead of the previous optional 5-word or 10-word options. This standardizes the test across all administrations and makes pre- to post-injury comparisons more reliable.
The Months in Reverse task — saying the months of the year backwards from December to January — is now timed, adding a processing speed component to what was previously only an accuracy check.
A new dual-task tandem gait assessment was added, requiring athletes to walk heel-to-toe while simultaneously performing a cognitive task (such as counting backwards). This dual-task paradigm, supported by research published in Gait & Posture and the Journal of Science and Medicine in Sport, captures deficits that neither motor nor cognitive testing alone would detect.
The Maddocks questions (orientation questions asked immediately after a suspected sideline injury) were updated with new items appropriate for different sports contexts.
What didn’t change
The core structure of symptom evaluation, cognitive screening, neurological examination, and balance testing (mBESS) remains intact. The graduated return-to-play protocol — a six-step progression from symptom-limited activity to full competition — is unchanged. And the fundamental principle that SCAT is a tool to assist clinical decision-making, not a standalone diagnostic, remains firmly in place. The Child SCAT6 (for athletes under 13) received parallel updates.
For families with existing baselines
A SCAT5 baseline can still be used as a general reference point, but we recommend updating to a SCAT6 baseline when possible. The new components — timed Months in Reverse and dual-task tandem gait — cannot be compared against a SCAT5 baseline because those elements weren’t measured in the earlier version.
At Headquarters, all baselines are now administered using SCAT6 protocols. If your athlete has an older SCAT5 baseline, we recommend scheduling an update to capture the new assessment components. For the full plain-English primer, see our SCAT6 explained guide and the Child SCAT6 overview.