ADHD linked to longer concussion recovery in high school athletes, UH study finds

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High school athletes diagnosed with attention-deficit/hyperactivity disorder (ADHD) take significantly longer to recover from concussions than their peers, according to new research from the University of Hawaiʻi at Mānoa.

The study, led by Kyoko Shirahata, a faculty member in the College of Education 's Department of Kinesiology and Rehabilitation Science, analyzed data from 935 student-athletes who sustained concussions between 2010 and 2018. The findings were recently published in the Journal of Athletic Training.

Researchers found that athletes with ADHD took an average of nearly 13 days to return to the classroom-about two days longer than their non-ADHD peers-and almost 21 days to return to their sport, a difference of roughly three days.

"Concussions are never one-size-fits-all, but our data show that ADHD can influence how long recovery can take," Shirahata said. "These students may need support tailored to their specific needs to return to learning and competition safely."

Female, younger athletes require longer recovery

The study also found that female athletes and younger students tended to have longer recovery periods. While previous studies hinted at these trends, this is one of the first large-scale efforts to isolate the effects of ADHD while accounting for sex and age.

The research used data collected by certified athletic trainers from 60 Hawaiʻi high schools, as part of a statewide concussion monitoring program.

"Our goal is to help athletes, coaches, families and healthcare providers understand that recovery timelines may vary for good reason," Shirahata said. "If we can tailor our care to each student's needs, we're doing our job."

College of Education Dean and study co-author Nathan Murata praised the work as an important step forward in student-athlete health.

"This study reflects our college's commitment to applied research that supports Hawaiʻi's youth," Murata said. "By better understanding how conditions like ADHD interact with sports injuries, we can create safer environments and smarter return-to-play decisions."

The researchers hope the findings encourage more individualized concussion management plans and highlight the importance of baseline testing and symptom tracking in high school sports.