If you have a child or teenager with attention deficit hyperactivity disorder, should you let him or her compete in a team contact sport like football or ice hockey? A new study suggests many young people with ADHD are drawn more to such competitions than to individual sports, according to findings by The Ohio State University Wexner Medical Center.

The results surprised researchers, who expected the athletes with ADHD – which is characterized by symptoms such as inattentiveness, hyperactivity or both – "to gravitate to individual sports that allow them to have more control and repetitiveness, like golf or martial arts," says Dr. James Borchers, one of the researchers and director of the division of sports medicine at the medical center. "In sports like these, they don't have to worry about their own responsibilities in addition to the roles of teammates and opponents." Instead of being drawn to individual sports, athletes with ADHD “were twice as likely to compete in team sports, and their rate of participation in contact sports, like football, hockey and lacrosse, was 142 percent higher,” Borchers says. He and fellow researchers presented the study recently at the American Medical Society for Sports Medicine’s annual meeting; it's an analysis of more than 850 athletes who played an array of sports at The Ohio State University. Nearly 6 percent of the athletes in the study were diagnosed with and treated for ADHD, which closely mirrors the percentage of ADHD found in the student population at large.

Though athletes with ADHD played more team contact sports than individual non-contact sports, researchers kept track of injuries sustained by the athletes and found there was no direct correlation between competing with ADHD and certain types of injuries. Researchers found no direct correlation among the athletes studied between competing with ADHD and sustaining certain sports-related injuries, such as concussions and injuries to the lower and upper extremities. However, athletes with ADHD may be at higher risk for injury, particularly in contact sports, says Dr. Trevor Kitchin, another physician who participated in the study. Some young people with ADHD have increased impulsivity, which could put them at higher risk for injuries, Kitchin says; further research is needed to verify such a link. Regardless, playing sports is generally a positive for young people with ADHD, he says. "Research has shown that participation in sports has been helpful in mitigating symptoms of ADHD by providing them some structure and focus in their everyday life," Kitchin says. "Even though there may be an increased risk of injury for athletes that have ADHD and play a contact sport, we still encourage parents to let their children try whatever sport they're interested in."

The study’s findings reflect the characteristics of many people with ADHD, says Dr. Jennifer Beck, associate director of the Center for Sports Medicine at the Orthopaedic Institute for Children in Los Angeles. “The main takeaway from this study is that different types of sports may attract different personality types in athletes. Personality characteristics, including psychological diagnoses such as ADHD, affect the willingness and way anyone participates or not in sports,” Beck says. “Sports such as fencing or table tennis attract a different personality type than football, high board diving or gymnastics. Sport choice is often related to an athlete’s willingness to take risks, and we know patients with ADHD have increased risk-taking behavior. This makes sense that they would be drawn to higher-risk sports.”

However, Beck and other clinicians point out, physical activity is helpful to people with ADHD. Research suggests that kids who exercise regularly experience gains in brain function and cognitive performance. “Most sports can be excellent for children with ADHD,” says Dr. Danelle Fisher, chair of pediatrics at Providence Saint John’s Health Center in Santa Monica, California. “Sports are a terrific way to channel the energy that kids with ADHD have. They can also help with learning how to function as part of a team as well as learning discipline and reaching goals outside of a classroom setting.” Dr. Oluseun Olufade, an assistant professor of Orthopaedics at Emory University School of Medicine in Atlanta, agrees: "There are reasons to encourage sports for kids with ADHD," he says. "Sports help with symptoms like hyperactivity and inattention."

For kids with ADHD, the pluses of playing sports, even games involving physical contact that might lead to injury, generally outweigh the risks of getting hurt on the field or on the court of play, clinicians say. “We’d love for kids with ADHD to participate more often in team sports,” says Yamalis Diaz, a clinical assistant professor in the department of child and adolescent psychiatry at NYU Langone Medical Center in New York City. Competing in sports can also help kids with ADHD who have less-than-optimal motor skills and who struggle in dealing with frustration. “Playing sports is good for learning how to manage frustration and improve one’s motor skills,” Diaz says.

Competing in sports can have other benefits, too, Diaz says. Some kids with ADHD don't do well in the classroom because they find it difficult to focus on their schoolwork. For a student who feels like he or she is constantly struggling in class, doing well in sports can prompt positive feedback, which is “intoxicating,” Diaz says. “They will throw themselves into their sport if they are hearing a lot of positive feedback. Who wouldn’t?”

For parents of kids and adolescents with ADHD who are considering playing sports, experts recommend these strategies:

Find the right sport. It’s important to find a sport that allows kids to feel successful and keeps them mentally engaged, Diaz says. “The brain is like a heat-seeking missile,” she says. “It needs sensory input. Any sport where you’re waiting for things to happen, that’s slow-paced, that is not the type of sport a kid with ADHD would be drawn to.” Some team sports, such as basketball, or individual sports, like swimming, have little downtime for players while they’re competing. Other sports, like baseball or softball, have downtime built in even for players on the field, because only the pitcher and catcher are involved in every pitch; meanwhile, their teammates stand in the field trying to be prepared if the ball is hit their way. That can be dangerous. For example, the mind of a child with ADHD who’s playing an outfield position in baseball may wander, “then here comes the ball, and it can smack you in the face if you’re not paying attention,” Diaz says.

Ask the coach to give your child a task to keep him or her engaged during down time. Rather than watching your child as he or she sits in the dugout while teammates take their turns at bat, ask the manager or coach to give him or her mind-engaging tasks. Such assignments could include providing water to teammates or logging plays or pitches on a clipboard. “If you give players a task like that, you’ve spoken to the brain, telling it, ‘You need to be focused on this,’” Diaz says.

Don’t discourage kids with ADHD from playing team sports. There are a lot of great benefits kids and teens get from being part of a team, from working off excess energy to learning how to socialize, how to manage frustration and even how to keep equipment organized. Some of these things may be particularly challenging for kids with ADHD, but that’s no reason to keep them off a team. “Teach them how to get through these things,” Diaz says.

Be sure there are good safeguards in place. Parents and coaches can identify whether a child with ADHD’s hyperactivity or impulsivity is affecting his or her ability to play a sport appropriately and take corrective measures, Diaz says. For instance, a young hockey player with ADHD might hit opponents on the ice a bit too enthusiastically or swing his or her hockey stick too high or too hard. Coaches and parents can work with the young athlete to teach him or her how to play appropriately.