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What ATs Need To Know About ADHD

Posted August 8, 2017

By Beth Wolfe, CAGS, ATC

Attention Deficit Hyperactivity Disorder (ADHD) is a complex, life-altering, and innate mental disorder that can be difficult to diagnose and accommodate within the athletic training environment. Patients with ADHD can present a wide variety of symptoms that encompass three core impairments: inattention and hyperactivity/impulsivity.1 These inattentive and hyperactive/impulsive behaviors can be mild, moderate, or severe which may impede the patient’s ability to function in an environment that exacerbates their symptoms. Unfortunately, the busy, loud natured and controlled-chaos of an athletic training facility will exacerbate the inattentive and hyper/impulsive behaviors of ADHD patients.2 Therefore, Athletic Trainers (ATs) need to be aware of a few key facts about this mental disorder so that they can best care for patients with ADHD.

Myths:

  1. Patients with ADHD can be cured with medication.
  2. ADHD is a behavior problem and not a disease/disorder.
  3. Patients with ADHD will outgrow their symptoms over time.

Facts:

  1. Medication (pharmacological) treatment can be used to help correct any chemical imbalances that are causing ADHD symptoms, but medications are not a cure. In order for a patient to receive pharmacological treatment for their ADHD they must meet strict clinical guidelines which must be documented and prescribed by a physician.3
  2. ADHD behaviors are signs and symptoms of a disorder and are not indicative of a behavior problem (e.g. rebelliousness, intentional disobedience, etc.).3 Remember, patients with ADHD are born with this mental disorder and cannot help or reverse the fact that they have this disorder. HOWEVER, we as ATs can provide an environment and care plan that accommodates their symptoms in order for them to thrive in an environment that is not made for them.2
  3. ADHD symptoms can be accommodated, controlled and lessened with various pharmacological, therapeutic and psychological/counseling interventions, but ADHD symptoms are permanent and are not outgrown.4

What does this mean for ATs? As healthcare providers, we need to accommodate these patients by altering our patient care and treatment environment. The time has come to shift the Athletic Training treatment paradigm so that these patients can thrive in an environment that is not made for them.5 How do we do this? For starters, what if ATs began to provide ADHD patients with coaching, attention, and encouragement for completing their daily rehabilitation/self-care rather than criticize and punishment these patient for non-compliance?6

We as healthcare providers should never punish or penalize our patients for displaying symptoms of a disorder/disease (e.g. being forgetful, losing focus, having too much energy), but we can be a catalyst for accommodating these patients so that their symptoms are lessened (e.g. creating a one-on-one treatment time with no one around, providing positive verbal encouragement for desired behaviors, other examples provided within Wolfe & Madden, 2017).2 ATs are valuable healthcare assets to those with ADHD and we should incorporate specific care plans for these patients so that they receive the best patient-centered care possible.


References:

  1. American Psychiatric Association. Attention deficit/hyperactivity disorder. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association Publishing; 2013: 5.
  2. Wolfe E, Madden K. Evidence-Based Considerations and Recommendations for Athletic Trainers Caring for ADHD Patients. J Athl Train. 2016; 51(10): 813-820.
  3. ADHD Institute. Disease management. ADHD-Institute.com. http://adhd-institute.com/disease-management/. Published January, 2017. Accessed July 17, 2017.
  4. Manos MJ. Nuances of assessment and treatment of ADHD in adults: a guide for psychologists. Prof Psychol Res Pract. 2010; 41(6):511–517.
  5. Wolfe E. ADHD and Athletic Training: It Is Time for a Paradigm Shift in Patient Care and Cultural Norms. The ADHD Report. 2017;25(3):8-9.
  6. Deal LS, Sleeper-Triplett J, DiBenedetti DB, Nelson L, McLeod L, Haydysch EE, Brown TM. Development and validation of the ADHD Bene ts of Coaching Scale (ABCS). J Atten Disord. 2015;19(3): 191-199. https://doi. org/10.1177/1087054714558118

About the Author

Beth wolfe

Elizabeth “Beth” Wolfe is the Injury Prevention Coordinator and Research Assistant for the Division of Trauma and Acute Care Surgery at Tufts Medical Center in Boston, Massachusetts. Wolfe completed her undergraduate degree at the University of South Carolina and her master’s and Certificate of Advanced Graduate Study at Boston University. Currently, Wolfe is pursuing her Doctorate of Health Science in Healthcare Administration and Leadership from Massachusetts College of Pharmacy and Health Sciences University. Within Massachusetts and the greater Boston area, Wolfe is a collaborator and lead author on numerous injury prevention projects and coalitions that revolve around road safety, fall prevention and brain trauma/concussion prevention. She is an active member of the National Athletic Trainers’ Association and is the District 1 Young Professionals Committee Representative and the Treasurer for the Athletic Trainers of Massachusetts.