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How can you support the mental health and performance of athletes with ADHD?



3-5% of children and 2% of adults are affected by ADHD. It’s likely you might know someone who has been diagnosed with ADHD. Given this, in the first blog of our mini-series, we looked at the symptoms and behaviours of ADHD, misconceptions around the condition, and the benefits of sport and exercise for ADHD.


In this post we will discuss the benefits of ADHD in a sporting environment, and some of the challenges that may be faced. This will further highlight that ADHD does not only present challenges, as the name ‘disorder’ suggests, but there are also positive aspects.


This will be followed by a list of top tips to support athletes with ADHD. This will help athletes with ADHD to reach their full potential in sport and experience optimal mental health. These tips are aimed at a sporting environment, but can also be applied to other contexts including the education system and workplace.


Benefits of ADHD in a sporting environment

The previous post discussed the benefits of sport to manage ADHD symptoms (e.g., emotional dysregulation and hyperactivity). But did you know that the symptoms of ADHD can also provide many benefits for sport? For example:

  • Doing well under chaos and pressure

  • Being full of energy

  • Showing enthusiasm

  • Fast reaction times

  • Spontaneity

  • Potentially having greater awareness of the environment

  • Coming up with creative ways of solving problems.

However, difficulties may include:

  • Planning, e.g., nutrition and remembering kit

  • Getting frustrated or angry

  • Listening to instructions

  • Being on time for training and matches

  • Potentially being at a greater risk of concussion which could be due to symptoms of ADHD or the physiology of the brain in individuals with ADHD.



Top Tips for supporting ADHD athletes


Using the positives of an individual’s ADHD symptoms, reducing their difficulties, and supporting their mental health requires a good relationship and understanding between the individual, and those supporting them (e.g., coaches and teammates).


When thinking of how to support ADHD athletes, it is important to understand the individuals' needs and openness to discussion. Some may find it difficult as open communication does not tend to be a common occurrence in society. The approach you take must be sensitive and individualized to the person’s specific needs and circumstances. Young athletes may require the involvement of parents/carers. These are some examples of what may help:


Listen to and want to understand

Don’t have your own assumptions about an individual’s ADHD. As symptoms may be masked (see: blog post 1), how individuals with ADHD appear to you, may not be how they are feeling or what they are experiencing.

Provide an open environment of communication to discuss their difficulties if they would like to do so. This includes discussing medication and potential side effects (to be discussed in the next blog) so that training can be adapted if necessary.


Keep talks at training short and simple

The longer the talks are, particularly when surrounded by lots of environmental stimuli, maximises the opportunity for distraction.

Keep talks short and minimise the number of instructions given at once. Be patient with the individual if you are expecting participation in a complex drill.


Minimise distractions

In large groups there are many distractions (noise, visual stimuli, and movement).

Talk to the individual in a small group if you have time, or one on one if you are both comfortable with doing so.


Have a structure at the start and the end but provide variety in between

Individuals with ADHD may lose focus if you do the same drill for a long time.

Have a set routine at the beginning and end of training and matches, to build in routine. Keep it exciting and their busy minds occupied by changing drills frequently.


Provide support for organization

Athletes at any level have additional requirements and potential stressors placed upon them. It can become overwhelming for those with ADHD who can struggle with organisation. For example, cooking and eating well to meet their energy requirements, and remembering all kit if going straight from school/university/work to training.

As a teammate you could ask them if they need any support in planning, and if you can do anything to help. For example, would a text the night before/on the morning of training or a match to provide reminders be helpful?

Don’t give them additional responsibilities that require further planning without asking and give them time to make a decision about taking on responsibilities. If they want to, support them in doing so.


Be forgiving

Some ADHD symptoms may come across as rude e.g. interrupting, fidgeting, or looking around when being spoken to.

Remember that these are not the fault of the individual so avoid calling them out for these behaviours.


When setting goals, break them down

As individuals with ADHD struggle with long-term planning, avoid large and long-term goals.

Break goals down so that they can be achieved quickly and managed by the athlete.


Praise them for doing well

Those with ADHD are likely to have low confidence and be highly critical of themselves.

Sport is a place that they can get a confidence boost. Let them know that they are doing well.

CONCLUSION & CALL TO ACTION

This post explained how ADHD can be beneficial in a sporting context, but also the difficulties and challenges that may be faced by athletes with ADHD. An understanding of these additional needs will enable the network surrounding athletes to best support them and reduce any additional sources of stress which could compromise their mental health. This support is not the responsibility of a single individual but requires a network (e.g., doctor, dietician, coach, and teammates) to work together.

The list of top tips gives examples of what can be done to support athletes with ADHD in sport. This can help them to perform optimally whilst experiencing a good quality of life. It is important that the approach is individualized to suit each person.

Next time, we will discuss:

  • Additional considerations when working with athletes with ADHD

  • ADHD medication and side effects

  • Certain ADHD medications as a prohibited substance in sport

  • Increased risk of mental health issues in those with ADHD.



Bio: This post was written by Kirsty Brown, an MSc by Research student in the School of Sport, Exercise and Rehabilitation Sciences at the University of Birmingham. Her research interests include mental health stigma, student athlete mental health, and mental health help-seeking in athletes.



Here are some resources used in this blog post if you want to read more: 


ADHD Project Subgroup CAMHS Advisory Group. (2018). Delivering effective services for children and young people with ADHD: Good practice guidance for commissioners and service providers across Greater Manchester. https://www.england.nhs.uk/north-west/wp-content/uploads/sites/48/2019/03/GM-wide-ADHD-guidance.pdf


Chuang, J. (n.d.). Tips for coaching the ADHD athlete. Retrieved October 25, 2021, from https://www.theathletesparent.com/single-post/2016/06/28/Tips-for-Coaching-the-ADHD-Athlete


I Have ADHD. (n.d.). A breakdown of adult ADHD symptoms. Retrieved October 18, 2021, from https://ihaveadhd.com/adult-adhd-symptoms/


Moodcafe. (n.d.). A coach’s guide to attention deficit hyperactivity disorder (ADHD). Retrieved October 18, 2021, from https://www.moodcafe.co.uk/media/43280/A Coach’s Guide to ADHD.pdf 


NHS. (2018). Symptoms of attention deficit hyperactivity disorder (ADHD). https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/symptoms/


PTS coaching. (2019, September 19). Helping kids with ADHD thrive in sports. https://ptscoaching.com/2019/09/helping-kids-with-adhd-thrive-in-sports/


Journal articles:


Alosco, M. L., Fedor, A. F., & Gunstad, J. (2014). Attention deficit hyperactivity disorder as a risk factor for concussions in NCAA division-I athletes. Brain Injury, 28(4), 472–474. https://doi.org/10.3109/02699052.2014.887145


Braun, R., & Braun, B. (2014). Managing the challenges of hidden disabilities in youth sport: A look at SLD, ADHD, and ASD through the sport psychology lens. Journal of Sport Psychology in Action, 6(1), 28–43. https://doi.org/10.1080/21520704.2014.991051


Franke, B., Michelini, G., Asherson, P., Banaschewski, T., Bilbow, A., Buitelaar, J. K., Cormand, B., Faraone, S. V., Ginsberg, Y., Haavik, J., Kuntsi, J., Larsson, H., Lesch, K. P., Ramos-Quiroga, J. A., Réthelyi, J. M., Ribases, M., & Reif, A. (2018). Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan. European Neuropsychopharmacology, 28(10), 1059-1088.  https://doi.org/10.1016/J.EURONEURO.2018.08.001


Iverson, G. L., Atkins, J. E., Zafonte, R., & Berkner, P. D. (2016). Concussion history in adolescent athletes with attention-deficit hyperactivity disorder. Journal of Neurotrauma, 33(23), 2077–2080. https://doi.org/10.1089/NEU.2014.3424


Nazeer, A., Mansour, M., & Gross, K. A. (2014). ADHD and adolescent athletes. Frontiers in Public Health, 0(JUN), 46. https://doi.org/10.3389/FPUBH.2014.00046


Poysophon, P., & Rao, A. L. (2018). Neurocognitive deficits associated with ADHD in athletes: A systematic review. Sports Health, 10(4), 317. https://doi.org/10.1177/1941738117751387


Pujalte, G. G., Maynard, J. R., Thurston, M. J., Taylor 3rd, W. C., & Mohit, C. (2019). Considerations in the care of athletes with attention deficit hyperactivity disorder. Clinical Journal of Sports Medicine, 29(3), 245–256. https://doi.org/10.1097/JSM.0000000000000508


Vargas, T., Flores, M., & Beyer, R. (2013). Theory into practice: Coaching athletes with hidden disabilities: recommendations and strategies for coaching education. A Journal for Physical and Sport Educators, 25(3), 32–33. https://doi.org/10.1080/08924562.2012.10592150


White, R. D., Harris, G. D., & Gibson, M. E. (2014). Attention deficit hyperactivity disorder and athletes. Sports Health, 6(2), 149. https://doi.org/10.1177/1941738113484679


Photos:

Photo 1 credit: @Nutvadee.Sermsree on Reshot

Photo 2 credit: @armisan on Reshot

Photo 3 credit: @RawVisualsPhotography on Reshot


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