neurocognitive scores in athletes with attention deficit-spectrum disorders
and/or learning disabilities
SL., Lee YM., Odom MJ., Solomon GS., Sills AK. Journal of Neurosurgery:
Pediatrics. 2013; ahead of print.
disorder and/or learning disabilities have lower baseline ImPACT neurocognitive
scores compared to athletes without attention deficit hyperactivity disorder
and learning disabilities.
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.
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.
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?
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