Is there a correlation between Attention-Deficit/Hyperactivity Disorder and concussions?
Visits to the pediatrician’s office for the assessment and treatment of concussion sustained by children and adolescents who participate in sports have become more frequent. According to one study which examined trends in ambulatory care for children who suffered a minor head injury, visits to the pediatrician for care related to concussion saw a dramatic 500% rise between 2007 and 2013. Against this backdrop, researchers are finding a correlation between a history of concussion and a diagnosis of Attention Deficit/Hyperactivity Disorder (ADHD) in children and adolescents. ADHD is a neurodevelopmental condition often characterized by behaviors such as inattention and impulsivity. Existing studies suggest that these characteristics of ADHD may be associated with an increased risk of physical injuries, including head injuries that can result in concussion.
Mason researchers conduct first large-scale study examining the association between ADHD and concussion in middle school athletes
Faculty and researchers from George Mason University’s Sports Medicine Assessment, Research & Testing (SMART) Laboratory and Mason’s Athletic Training Education program within the School of Kinesiology recently conducted a study to examine the association between ADHD and history of concussion in middle school athletes. Several previous investigations have examined this correlation among high school and university students. The Mason study, however, is the first large-scale study of its kind to focus on children and adolescents in middle school.
As part of this investigation, middle school students from Prince William County Public Schools completed baseline, preseason evaluation with a certified athletic trainer using the Child Sport Concussion Assessment Tool, 5th Edition (Child SCAT5) which is a standardized tool used in supporting the diagnostic assessment of concussion and in screening youth before they participate in a school sport. The Mason study included 1,037 children and adolescent athletes, ages 11 through 14. They were asked to complete a health history questionnaire that is part of the Child SCAT5 including a question on whether they had ever been diagnosed with ADHD. Study participants were also asked to self-report whether they had sustained one or more concussions in the past. The responses of the children diagnosed with ADHD were compared with those who did not report having ADHD.
The study results showed that children with ADHD had a rate of previous concussion twice that of children without ADHD
Of the 1,037 students selected to participate in the study, 127 self-reported a medical history of one or more concussions. Within this group, 17 or 23.9% of those with ADHD reported that they had previously suffered one or more concussions. In contrast, 110 or 11.4% of students who did not have ADHD reported a history of one or more past concussions. These results showed that the rate of previous concussion in students who had ADHD was about twice that reported by those who did not have ADHD.
Researchers caution that the study findings indicating an association between ADHD and history of concussion are correlational in nature and should not be interpreted to be a causal relationship. In addition, researchers note that the study had certain limitations. Among these, researchers could not confirm the ADHD status of the study participants because they did not have access to student medical records nor were they able to confer with parents in verifying the self-reported responses to the questionnaire made by the students. This is important because existing studies show that adolescents with ADHD frequently experience concussion-like symptoms, such as headaches, dizziness, or nausea, despite not having a head injury. Some researchers suggest that it is possible that ADHD can “mimic” the clinical symptoms of concussion.
Researchers recommend further studies to determine if children with ADHD are at greater risk of concussion
The study co-authors recommended that further studies should be conducted to determine whether children with ADHD are at a greater risk of sustaining concussion compared with those who do not have ADHD. Researchers stated that future investigations should include a process allowing for the confirmation of ADHD status through medical record review, formal diagnostic evaluation, or corroboration with parents. They also cited the need for research on the short, medium, and long-term outcomes from sport-related concussion in middle school students with ADHD that would provide guidance on the best medical and academic strategies for returning these students to school and to sports.
To learn more about the association between ADHD and concussion, read this article by faculty from George Mason University’s School of Kinesiology. The highly regarded Athletic Training Education program within Mason prepares students with the knowledge, clinical skills, and reasoning abilities necessary to practice effectively as a certified athletic trainer and the Mason Kinesiology program provides a comprehensive approach to the study of human movement. We invite you to explore our degree offerings by visiting our web site.