Middle School Children With Attention-Deficit/Hyperactivity Disorder Have a Greater Concussion History.

Objective: Examine lifetime history of concussions in middle school student athletes who have attention-deficit/hyperactivity disorder (ADHD).

Design: Cross-sectional study.

Setting: Nine middle schools in Virginia, USA.

Participants: A sample of 1037 middle school students (ages 11-14 years, M = 12.6, SD = 0.93; 45.8% girls) underwent baseline/preseason assessments during the 2017 to 2018 academic year and self-reported their health history, including whether or not they had been diagnosed with ADHD. Athletes were divided into 2 groups, those with ADHD (n = 71; 6.8%) and control subjects (n = 966).

Independent Variables: Self-reported diagnosis of ADHD and self-identified sex.

Main Outcome Measures: Self-reported concussion history.

Results: In the total sample, boys were more likely to report a previous history of concussion than girls [χ2(1) = 10.81, P = 0.001; odds ratio (OR) = 1.92; 95% confidence interval (CI), 1.30-2.85]. The rate of previous concussion in children with ADHD (23.9%) was twice the rate of previous concussion among children without ADHD (11.4%) [χ2(1) = 9.70, P = 0.002; OR = 2.45; 95% CI, 1.37-4.38]. Approximately 1 in 4 boys with ADHD (24.5%) and 1 in 5 girls with ADHD (22.2%) reported having sustained one or more previous concussions.

Conclusions: Attention-deficit/hyperactivity disorder is associated with a greater prevalence of previous concussion in middle school children. Further research is needed to understand the risk of sustaining concussion for young athletes with ADHD, as well as short- and long-term outcomes of concussion among young athletes with ADHD.