Stories about the negative effects of concussions on brain health and function are popping up everywhere. As awareness grows, coaches, sports organizations, and parents are making changes to the way practices are conducted, how games are played, and how youths are monitored when a concussion occurs, all with the goal of preventing concussions and reducing their short- and long-term effects.
Recent studies suggest that youths with ADHD may be particularly vulnerable to the effects of concussions and may require additional monitoring and follow-up care. While these studies are preliminary and were conducted with college student-athletes, the findings are concerning for all youths with ADHD.
Recently, a study of college athletes found that those with ADHD may be slower to recover from a concussion than those without ADHD. The study included 120 participants, 40 with ADHD and 80 without ADHD. It measured concussion-related factors (like memory, processing speed, and concussion-specific symptoms) before the start of the season, two days after their concussion, and again once they were cleared to return to play.
Athletes with ADHD experienced greater decline in memory function and had more severe concussion symptoms two days after the injury compared to injured athletes without ADHD. Those with ADHD also continued to have more difficulties with some aspects of thinking and learning at the time that they were cleared to play. Concussion symptoms also lasted longer for athletes with ADHD – 10-12 days for athletes with ADHD versus four days for athletes without ADHD.
A separate study of almost 1,000 college athletes found that those with ADHD were at higher risk of experiencing anxiety and depression following a concussion than athletes without ADHD. This is particularly concerning because anxiety and depression are not regularly monitored as part of standard concussion treatment protocols.
While the findings from these studies are preliminary, they are concerning. More research is clearly needed, especially in children and teens, but in the meantime, what should parents do to protect their children with ADHD? Physical activity and participation in team sports both come with great benefits for kids and teens with ADHD, so continuing to participate in sports is important. Unfortunately, many sports, from soccer to cheerleading, come with significant concussion risks.
One of the best things parents can do is to ensure that their child is participating in a sports program that follows safe play practices to minimize concussion risk, and that responds quickly and effectively when a concussion is suspected. Parents should inform coaches and doctors that their child or teen requires additional monitoring because of their ADHD and may take longer to recover from a concussion.
In addition, children and teens with ADHD should be closely monitored for symptoms of anxiety and depression in the weeks and months following the injury. For additional helpful information on preventing, recognizing, and responding to a concussion, as well as knowing what to look for in coaches and sports programs that follow progressive concussion prevention and management guidelines, check out the CDC’s HEADS UP to Youth Sports website.
Mary Rooney, Ph.D., is a licensed clinical psychologist in the Department of Psychiatry at the University of California San Francisco. Dr Rooney is a researcher and clinician specializing in the evaluation and treatment of ADHD and co-occurring behavioral, anxiety, and mood disorders. A strong advocate for those with attention and behavior problems, Dr. Rooney is committed to developing and providing comprehensive, cutting edge treatments tailored to meet the unique needs of each child and adolescent. Dr. Rooney's clinical interventions and research avenues emphasize working closely with parents and teachers to create supportive, structured home and school environments that enable children and adolescents to reach their full potential. In addition, Dr. Rooney serves as a consultant and ADHD expert to Huntington Learning Centers.
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