Attention-deficit/hyperactivity disorder is associated with baseline child sport concussion assessment tool third edition scores in child hockey players

ABSTRACT

Objectives: The objectives of this study were to report baseline, preseason data for the Child-SCAT3, stratified by attention deficit hyperactivity disorder (ADHD) status, and examine group differences in Child-SCAT3 performance between children with and without ADHD.

Design: Cross-sectional study.

Methods: Young male hockey players (n = 304), aged 8–12 years, were administered the Child-SCAT3 during pre-season. Child-SCAT3 measures included a 20-item symptom scale, a Standardised Assessment of Concussion Child Version (SAC-C), a modified Balance Error Scoring System (m-BESS), a tandem gait task, and a coordination test.

Results: Children with ADHD (n = 20) endorsed significantly more symptoms (d = 0.95) and greater symptom severity (d = 1.13) compared to children without ADHD. No statistically significant differences were found between groups on Child-SCAT3 measures of cognitive or physical functioning (e.g. balance and coordination).

Conclusions: ADHD should be considered when interpreting Child-SCAT3 scores, especially symptom reporting, in the context of concussion assessment. Better understanding of symptom reporting in uninjured child athletes with ADHD can inform the clinical interpretation of symptoms at baseline and following an actual or suspected concussion. Normative data for the Child-SCAT3 that is not stratified by or otherwise accounts for ADHD status should be used with caution when appraising performance of children with ADHD.

KEYWORDS:

• Brain
• concussion
• Child-SCAT3
• traumatic brain injury
• cognition

Acknowledgments

We would like to thank all the players and parents from the Seafair Minor Hockey Association for their participation in the study. We are also grateful to Evolution Sport therapy (Richmond, BC) for providing testing equipment, space, and expertise. We appreciate the funding provided as an unrestricted grant by the ERIN fund, British Columbia Neuropsychiatry Program. GLI and NEC acknowledge unrestricted philanthropic support from the Mooney-Reed Charitable Foundation and ImPACT Applications, Inc.

Declaration of interest

GLI has been reimbursed by the government, professional scientific bodies, and commercial organizations for discussing or presenting research relating to MTBI and sport-related concussion at meetings, scientific conferences, and symposiums. He has a clinical practise in forensic neuropsychology involving individuals who have sustained mild TBIs. He has received honorariums for serving on the research panels that provide scientific peer review of programmes. He is a co-investigator, collaborator, or consultant on grants relating to mild TBI funded by several organizations. WJP has a private practise in forensic Neuropsychiatry. All other authors declare no conflicts or interests.

Funding

This work was supported by the ERIN fund, British Columbia Neuropsychiatry Program.

Additional information

Funding

This work was supported by the ERIN fund, British Columbia Neuropsychiatry Program.