Lifetime History of Concussion in Children With Attention-Deficit/Hyperactivity Disorder

Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for concussion. Sociodemographic differences in health literacy and access to health care might contribute to race-associated differences in concussion among children. This study investigated associations between ADHD, sex, race, and self-reported lifetime concussion history in children who participate in sports. A sample of 12 607 children (ages 9-12 years; 45.3% girls; 70% White, 9.6% Black, 1.8% Asian; and 10.9% with ADHD) completed pre-season baseline testing. They self-reported their sex, race, history of ADHD, and history of concussion. A significantly greater proportion of children with ADHD self-reported a history of concussion (19.3% vs 12.4% without ADHD; P < .001, odds ratio = 1.69, 95% CI 1.44-1.73). Comparing subgroups, girls (19.2% vs 10.2%), boys (19.4% vs 14.5%), White children (17.9% vs 13.3%), White girls (18.9% vs 10.8%), and White boys (20.4% vs 15.5%) with ADHD were significantly more likely to report a history of concussion than those who do not have ADHD. There is a need to better understand how socioeconomic status, racial disparities in concussion knowledge and access to health care, and social determinants of health contribute to how children conceptualize and report their lifetime history of concussion.