Baseline
neurocognitive scores in athletes with attention deficit-spectrum disorders
and/or learning disabilities
neurocognitive scores in athletes with attention deficit-spectrum disorders
and/or learning disabilities
Zuckerman
SL., Lee YM., Odom MJ., Solomon GS., Sills AK. Journal of Neurosurgery:
Pediatrics. 2013; ahead of print.
SL., Lee YM., Odom MJ., Solomon GS., Sills AK. Journal of Neurosurgery:
Pediatrics. 2013; ahead of print.
Take Home Message: Athletes with attention deficit hyperactivity
disorder and/or learning disabilities have lower baseline ImPACT neurocognitive
scores compared to athletes without attention deficit hyperactivity disorder
and learning disabilities.
disorder and/or learning disabilities have lower baseline ImPACT neurocognitive
scores compared to athletes without attention deficit hyperactivity disorder
and learning disabilities.
Developmental, behavioral, and
learning disabilities affect approximately 1 in 6 children in the United States.
Children with attention deficit hyperactivity disorder (ADHD) suffer more head
injuries compared with those without the disorder. Unfortunately, nearly all
neurocognitive assessment studies exclude athletes with ADHD or learning
disabilities despite the fact we need normative ImPACT scores for this
population so we can adequately assess them. Therefore, the purpose of this
study was to assess baseline neurocognitive differences between athletes with or
without ADHD or learning disabilities and to establish normative data for these
populations. The authors analyzed 6636 athletes previously completed baseline
ImPACT scores that they defined as valid based on an impulse composite score of
>30. From this sample the authors identified 1) 90 athletes with a
self-reported history of learning disability, 2) 262 athletes with a
self-reported history of ADHD, and 3) 55 athletes with a self-reported history
of learning disability and ADHD. The authors matched these athletes to athletes
without ADHD and learning disability based on age, sex, years of education,
height, weight, and concussion history. Athletes with ADHD had lower verbal
memory, visual memory, and visual motor process, as well as higher reaction
time, impulse control, and symptom score compared with the matched athletes
without ADHD and learning disability. Athletes with learning disabilities had a
similar ImPACT score pattern as those with ADHD except they had similar impulse
control compared with athletes with no learning disabilities and ADHD.
learning disabilities affect approximately 1 in 6 children in the United States.
Children with attention deficit hyperactivity disorder (ADHD) suffer more head
injuries compared with those without the disorder. Unfortunately, nearly all
neurocognitive assessment studies exclude athletes with ADHD or learning
disabilities despite the fact we need normative ImPACT scores for this
population so we can adequately assess them. Therefore, the purpose of this
study was to assess baseline neurocognitive differences between athletes with or
without ADHD or learning disabilities and to establish normative data for these
populations. The authors analyzed 6636 athletes previously completed baseline
ImPACT scores that they defined as valid based on an impulse composite score of
>30. From this sample the authors identified 1) 90 athletes with a
self-reported history of learning disability, 2) 262 athletes with a
self-reported history of ADHD, and 3) 55 athletes with a self-reported history
of learning disability and ADHD. The authors matched these athletes to athletes
without ADHD and learning disability based on age, sex, years of education,
height, weight, and concussion history. Athletes with ADHD had lower verbal
memory, visual memory, and visual motor process, as well as higher reaction
time, impulse control, and symptom score compared with the matched athletes
without ADHD and learning disability. Athletes with learning disabilities had a
similar ImPACT score pattern as those with ADHD except they had similar impulse
control compared with athletes with no learning disabilities and ADHD.
A baseline neurocognitive exam is a crucial
part to the post-concussion assessment by helping clinicians assess when the
athlete may return to play. Without valid baseline scores or normative data
this can make evaluating and treating a concussion difficult. The current study
suggests that athletes with ADHD or learning disabilities may have different
ImPACT baseline scores on all 5 neurocognitive parameters and 1 symptom
parameter. Additionally, the authors present preliminary baseline normative
data for adolescents with ADHD and/or learning disabilities. However, further
research may be needed to determine if the ImPACT scores from this study are representative
of athletes with ADHD or learning disabilities around the country and in
different age groups. Additionally, the authors did not note the frequency of
invalid baseline tests. If the frequency of invalid tests is high within this
special population then ImPACT tests may be an inappropriate tool for assessing
concussions and deciding on return to play among these athletes. Medical
professionals should be aware of the differences in baseline composite scores
for those with learning disabilities and/or ADHD.
part to the post-concussion assessment by helping clinicians assess when the
athlete may return to play. Without valid baseline scores or normative data
this can make evaluating and treating a concussion difficult. The current study
suggests that athletes with ADHD or learning disabilities may have different
ImPACT baseline scores on all 5 neurocognitive parameters and 1 symptom
parameter. Additionally, the authors present preliminary baseline normative
data for adolescents with ADHD and/or learning disabilities. However, further
research may be needed to determine if the ImPACT scores from this study are representative
of athletes with ADHD or learning disabilities around the country and in
different age groups. Additionally, the authors did not note the frequency of
invalid baseline tests. If the frequency of invalid tests is high within this
special population then ImPACT tests may be an inappropriate tool for assessing
concussions and deciding on return to play among these athletes. Medical
professionals should be aware of the differences in baseline composite scores
for those with learning disabilities and/or ADHD.
Questions for Discussion: When we use ImPACT tests among
athletes with ADHD do you think medication use influences the results? Do you
think athletes with ADHD or learning disabilities will ImPACT test differently if
they are tested individually instead of in a group?
athletes with ADHD do you think medication use influences the results? Do you
think athletes with ADHD or learning disabilities will ImPACT test differently if
they are tested individually instead of in a group?
Written by: Jane McDevitt PhD, ATC,
CSCS
CSCS
Reviewed by: Jeffery Driban
Related
Posts:
Posts:
Zuckerman SL, Lee YM, Odom MJ, Solomon GS, & Sills AK (2013). Baseline neurocognitive scores in athletes with attention deficit-spectrum disorders and/or learning disability. Journal of Neurosurgery. Pediatrics PMID: 23790088
I think this post is very relevant when referring to today’s athletes. There are more kids than ever being diagnosed with ADHD and learning disabilities than ever before. Whether it is a growing prevalence of these disorder or better recognition tools is also part of the issue. Regardless of the reasons, it is something that needs to be taken into consideration when administering and evaluating ImPACT scores. I think that medication has a very large influence on the results of this test, and need to be considered when administering baseline tests and retests. The medications for this disorder affect the attention of an individual. The ability to focus and concentrate on specific directions and tasks are a huge part of the ImPACT test. Changes in concentration abilities would most certainly affect how well or poorly an athlete scores on this test. That being said, I don’t necessarily think that the scores would change if the athlete is tested in a room alone or with a whole group of people, as long as adequate space and visual or auditory barriers are provided in the testing site, but I think that should be standard throughout, not just for those with ADHD. What I think needs to be taken into consideration is if the athlete has taken the medication or not before the baseline test and retest. If the athlete had not taken medication before the baseline, then they should take the retest under the same condition and vice versa. Otherwise, I don’t believe that you would be able to accurately compare the two tests or determine the extent of cognitive deficits following a concussion.
Hi,
Healthline just published this infographic outlining ADHD statistics and numbers in a visual guide. You can see the graphic here: https://www.healthline.com/health/adhd/facts-statistics-infographic
Our users found this info very useful as it showcases the high cost of ADHD and which states ADHD is most prevalent in, and I thought it would be a great resource for your page: https://www.sportsmedres.org/2013/07/ImPACT-Testing-ADHD-Learning-Disability.html
Please take a look at the guide and consider adding it to your page. The graphic is also embeddable, so you can embed just the images if you choose to do so.
Thanks again and let me know if you have any questions.
Best,
Maggie Danhakl • Assistant Marketing Manager
Healthline • The Power of Intelligent Health
660 Third Street, San Francisco, CA 94107
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