Mental Health Performance - What Athletes Need To Know Part III. ADHD, Autism & Psychological Performance In Sports
About the Author
Ben Foodman is a licensed psychotherapist & performance specialist. He owns his private practice located in Charlotte North Carolina where he specializes in working with athletes to help them overcome mental blocks (the yips), PTSD, ADD / ADHD and achieve flow states through the techniques of Brainspotting & Neurofeedback. If you are interested in services, use the link here! Enjoy the article below!
Introduction: ADHD, Autistic Spectrum Disorder & Athlete Considerations
Athletes bring different psychological strengths into their performances. Unfortunately, what are often strengths are frequently misdiagnosed as weaknesses. As such, athletes that present with these characteristics are oftentimes punished and told that they need to ‘hide’ these features. Two common mental health diagnoses that are initially identified as weaknesses rather than strengths are ADHD and Autistic Spectrum Disorder (ASD). The truth is that these ‘disorders’ are advantages, and athletes with these diagnoses are actually huge assets to their team and/or sport.
For this issue of the Training Report I want to review details about ADHD and Autistic Spectrum Disorder (ASD). First in part I. I want to review traditional diagnostic criteria for these diagnoses. Next in part II. I want to review different strengths that athletes with these diagnoses bring into sports competition. Finally in part III. I want to review different therapies and interventions that have been shown to potentially help enhance the psychological performances of these athletes. Let’s first begin by reviewing the diagnostic criteria for ADHD and ASD.
Part I. Traditional Diagnostic Considerations For ADHD & Autistic Spectrum Disorder (ASD)
It’s important to first begin to develop an understanding of the clinical definitions of ADHD & ASD. Starting with ADHD, the DSM states the following ‘The essential feature of attention-deficit/hyperactivity disorder (ADHD) is a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. Inattention manifests behaviorally in ADHD as wandering off tasks, lacking persistence, having difficulty sustaining focus, and being disorganized and is not due to defiance or lack of comprehension. Hyperactivity refers to excessive motor activity (such as a child running about) when it is not appropriate or excessive fidgeting, tapping, or talkativeness. In adults, hyperactivity may manifest as extreme restlessness or wearing others out with their activity. Impulsivity refers to hasty actions that occur in the moment without forethought and that have high potential for harm to the individual. Impulsivity may reflect a desire for immediate rewards or an inability to delay gratification. Impulsive behaviors may manifest as social intrusiveness (e.g. interrupting others excessively) and/or making important decisions without consideration of long-term consequences (e.g. taking a job without adequate information).
In reference to ASD, the DSM explains this diagnosis in the following way ‘Autism Spectrum Disorder is characterized by persistent deficits in social communication and social interaction across multiple contexts, including deficits in social reciprocity, nonverbal communicative behaviors used for social interaction, and skills in developing, maintaining and understanding relationships, In addition to the social communication deficits, the diagnosis of autism spectrum disorder requires the presence of restricted, repetitive patterns of behavior, interests, or activities. Because symptoms change with development and may be masked by compensatory mechanisms, the diagnostic criteria may be met based on historical information, although the current presentation must cause significant impairment.’ While somewhat dated, in the book Biofeedback & Neurofeedback Application In Sport Psychology, the authors go on to review how autistic athletes and ADHD athletes bring many strengths to the field of sport performance such as an ability to over-focus intensely on technical aspects or enhanced creativity. Let’s dive deeper into the many strengths that athletes and coaches need to know about as it pertains to ADHD & ASD.
Part II. Neuroscience Considerations & Performance Advantages For Athletes With ASD & ADHD
The authors Strack, Linden & Wilson go on to explain the benefits ADHD and ASD athletes have as it relates to their diagnoses ‘Some sports do not require intense concentration for long periods but rather short bouts of attention (15 seconds) or short shifts as in football or hockey. Athletes with ADHD perform better in individualized or fast sports; they have quick speed and reaction time if they can control their impulsivity. Athletes with ADHD have a heightened awareness of their environment. They have the ability to do well under pressure and under chaotic situations, for example, a quarterback rolling out to avoid a rush and completing a pass across the field. Athletes with ADHD have unique and creative problem solving abilities and can make a novel play out of a problem situation. Because their impulsivity leads them to often live in the present, they also have a lack of concern about losing at the moment’.
The authors continue ‘Many athletes with autism and Asperger’s are undiagnosed yet excel at technical positions (e.g. catcher, goalie, surfing, running, martial arts). These athletes are often described as quirky, or loners and develop numerous routines that need to be followed in order for them to be successful. Some of the advantages of having Asperger’s in sports are being able to over-focus on technical aspects, such as throwing a curveball, three-point shooting, making the perfect jump in skiing, turning in surfing, or goalie save techniques. They are able to hyper-focus on their techniques and practice for long periods of time. The most successful athletes can increase their hyper-focusing when necessary, such as a pitcher in a full pitch count or a goalie in a shootout. In addition, athletes with Asperger’s have a greater ability to stay calm in high-pressure situations and when they make a mistake as a result of having less emotional responsivity’.
Part III. Sport Psychologists, Neurofeedback & Athletes
Neurofeedback or EEG biofeedback has been used with individuals with ADD since 1976 and is becoming more mainstream as a non-drug intervention for ADD/ADHD without side effects. Neurofeedback is also used with ASD which began in 2002. Since 2004, sport psychologists and researchers have been using QEEG informed neurofeedback with individuals with ASD to specifically target improvements in communication, socialization, anxiety, obsessiveness, and overactive behavior. Neurofeedback works through Operant Conditioning, which is a form of learning that uses a reward to modify behavior. For example, during a neurofeedback session as the brainwaves change in a healthier way, athletes may hear a bell ring or will see a visual image changing on a computer screen during the session.
This feedback encourages the brain to more easily move into healthier functional ranges over time. Research shows that neurofeedback promotes healthier blood flow to the cortex of the brain, and after repeated sessions long standing changes are maintained long after Neurofeedback training is complete. There is also research that supports the application of QEEG Mapping in sports with a focus on concussions, ‘The QEEG Map usually displays an abnormal pattern of slow activity and coherence/connectivity abnormalities in the area where a closed head injury or concussion occurred. Neurofeedback can be used to treat concussion symptoms such as headaches and memory loss’.
The reason professionals use the QEEG is to help guide neurofeedback interventions for the following reasons ‘it is the statistical analysis of the electrical activity of the brain. It is a brain-mapping tool used to evaluate differences in brain function compared to database of people without difficulties. The QEEG is based on an EEG recording monopolar electrodes from 19 scalp locations according to the international 10-20 system referenced to the right and left earlobes. Delta (0-4Hz), Theta (4-8Hz), Alpha (8-12Hz), Beta (15-20Hz), SMR (12-15Hz), and EMG (20-32Hz) brainwave frequencies are recorded during eyes-open visual attention, reading, and eyes-closed conditions’.
Some of the excesses and deficits discovered in a Q are abnormal and are related to specific behavioral and/or attention difficulties, anxiety or mood disorders. As previously stated, the QEEG enables the formulation of treatment options guided by the brain patterns associated with abnormal behaviors rather than relying only on symptoms and behavioral measures, ‘This procedure has been normed on thousands of children-adults in several multisite research studies. The research studies on the QEEG indicate sensitivity and specificity greater than 88 percent for ADHD. Biological brain-imaging tests such as the QEEG, SPECT, and PET scans are becoming the most accurate tests for diagnosing biological based ADHD and ASD’.
Note To Reader:
If you are an athlete reading this segment of the TRAINING REPORT, hopefully this content was helpful! I put the Training Report together because I felt like many of the discussions on issues such as the Yips/mental blocks, strength training & other subject matter on athlete performance concepts were really missing the mark on these ideas (e.g. how trauma is the direct cause of the Yips). If you are interested in learning more, make sure to subscribe below for when I put out new content on issues related to sport psychology & athlete performance! Also, if you are looking to work with a mental performance specialist, you are in the right place! USE THIS LINK to reach out to me to see if my services are the right fit for your goals!
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